Imperial College London
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ProfessorChristopherMillett

Faculty of Medicine, School of Public Health

Professor of Public Health
 
 
 
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Contact

 

c.millett Website

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Dalton:2014:10.1371/journal.pone.0083705,
author = {Dalton, A and Vamos, E and Harris, M and Netuveli, G and Wachter, B and Majeed, A and Millett, C},
doi = {10.1371/journal.pone.0083705},
journal = {PLoS ONE},
title = {Impact of universal coverage on hypertension management: a cross-national study in the United States and England},
url = {http://dx.doi.org/10.1371/journal.pone.0083705},
volume = {9},
year = {2014}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: The Patient Protection and Affordable Care Act (ACA) galvanised debate in the United States (US) overuniversal health coverage. Comparison with countries providing universal coverage may illustrate whether the ACA canimprove health outcomes and reduce disparities. We aimed to compare quality and disparities in hypertensionmanagement by socio-economic position in the US and England, the latter of which has universal health care.Method: We used data from the Health and Retirement Survey in the US, and the English Longitudinal Study for Aging fromEngland, including non-Hispanic White respondents aged 50–64 years (US market-based v NHS) and .65 years (USMedicarev NHS) with diagnosed hypertension. We compared blood pressure control to clinical guideline (140/90 mmHg)and audit (150/90 mmHg) targets; mean systolic and diastolic blood pressure and antihypertensive prescribing, anddisparities in each by educational attainment, income and wealth, using regression models.Results: There were no significant differences in aggregate achievement of clinical targets aged 50 to 65 years (US marketbasedvs. NHS- 62.3% vs. 61.3% [p = 0.835]). There was, however, greater control in the US in patients aged 65 years and over(US Medicare vs. NHS- 53.5% vs. 58.2% [p = 0.043]). England had no significant socioeconomic disparity in blood pressurecontrol (60.9% vs. 63.5% [p = 0.588], high and low wealth aged $65 years). The US had socioeconomic differences in the 50–64 years group (71.7% vs. 55.2% [p = 0.003], high and low wealth); these were attenuated but not abolished in Medicarebeneficiaries.Conclusion: Moves towards universal health coverage in the US may reduce disparities in hypertension management. Thecurrent situation, providing universal coverage for residents aged 65 years and over, may not be sufficient for equality incare.
AU  - Dalton,A
AU  - Vamos,E
AU  - Harris,M
AU  - Netuveli,G
AU  - Wachter,B
AU  - Majeed,A
AU  - Millett,C
DO  - 10.1371/journal.pone.0083705
PY  - 2014///
SN  - 1932-6203
TI  - Impact of universal coverage on hypertension management: a cross-national study in the United States and England
T2  - PLoS ONE
UR  - http://dx.doi.org/10.1371/journal.pone.0083705
UR  - http://hdl.handle.net/10044/1/58343
VL  - 9
ER  -
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