Factors associated with continuity of care among hypertensive patients registered at Embu hospital medical outpatient clinic in Embu county, eastern Kenya

Abstract

Background: Continuity of care in hypertension care has been shown to improve blood pressure control and other related health outcomes for patients as evidenced by studies conducted in the developed world. Globally the prevalence of hypertension is high and that includes Sub Saharan Africa and in particular Kenya. This calls for an approach that can improve the care process and keep patients’ Hypertension under control. In Kenya there is no published data and little is known about the extent of the level of continuity of care and related factors in the health system of Kenya. This study set out to estimate the Continuity of care index and determine factors associated with it among hypertensive patients registered with a medical outpatient clinic (MOPC) in Embu Level 5 hospital one of the regional hospitals. Methods: The study design was cross sectional. Sample size was 369 hypertensive patients registered at Embu County hospital MOPC. Systematic Random Sampling was done for patients who fulfilled the inclusion criteria. Data was collected using interviewer administered structured questionnaire. The level of COC was determined using the Most Frequent Provider Continuity (MFPC) index. Data analysis was done using STATA version 12software. Multivariable Regression analysis was done to determine the factors associated with COC. Results: The mean age of the participants was 63.7years (SD: 14.7), 79.67% of the participants were female, the language most commonly spoken was Kiembu (80.2%) and 44.7 % of the participants had only attained primary education. The MFPC index was 0.39± 0.16. The factors associated with continuity of care were: No co-morbidity P= 0.000, satisfaction of the patient with the provider P= 0.000, consultation time with the patient P= 0.002, Patient’s choice to see a provider at the health facility P=0.004 and the gender of the provider P=0.001. Conclusion: The level of COC among hypertensive patients was low. The associated factors included; satisfaction with the provider, consultation time with the patient, the health facility’s allowance of patients to see a Health provider of their choice, and gender of the Health provider.