IMPROVING THE TREATMENT AND CONTROL OF HYPERTENSION

候选人：凯伦·马戈利斯，医学博士，M.P.H.，明尼阿波利斯医学研究基金会伯曼结局和临床研究中心成员，明尼苏达大学附属教学医院亨内平县医学中心的专职医生。马戈利斯博士感兴趣的是找到将患者、医生和护理系统结合在一起的干预措施，以实施有效的医疗护理，特别是在心血管疾病预防领域。职业目标。马戈利斯博士目前的职业目标包括：(1)流行病学、生物统计学、卫生服务研究、研究设计和分析方面的高级课程工作；(2)与伯曼中心多中心临床试验和前瞻性研究合作；(3)与Mentor合作，开发和评估研究方向、技能和经验；(4)获得资金，并在管理医疗机构中实施医生激励措施的试点和全面研究，以改善高血压的控制；以及(5)开发其他相关研究项目。马戈利斯博士的长期职业目标包括在以患者为导向的心血管疾病预防研究领域获得独立的研究人员地位，并将医生和患者采用有效干预措施的主题纳入预防心血管疾病发病率和死亡率的护理系统。研究计划。在获奖的五年期间，马戈利斯博士计划进行至少一项重大临床试验，并在此之前进行一项试点研究。这项名为“改善高血压治疗和控制计划(PING)”的临床试验和先导研究将测试这样一种假设，即接受资助以设计自己的高血压控制计划的管理型保健组织中的诊所，与获得类似资金以获得经济奖励(根据业绩直接提供给医生)的诊所和没有获得财政奖励的对照诊所相比，高血压患者控制血压的比例更高。马戈利斯博士还计划了其他几个相关项目，其中包括：(1)研究患者对医生经济激励的态度和对Pitch护理的满意度；(2)研究Pitch医生经济激励对高血压以外的医疗服务的影响；以及(3)患者健康状况偏好在接受高血压治疗和控制高血压方面的作用。

Candidate: Karen Margolis, M.D., M.P.H., is a member of the Berman Center for Outcomes and Clinical Research at the Minneapolis Medical Research Foundation, and staff physician at Hennepin County Medical Center, a teaching hospital affiliated with the University of Minnesota. Dr. Margolis is interested in finding interventions which bring patients, physicians and the system of care together to implement effective medical care, specifically in the area of cardiovascular disease prevention. Career Objectives. Dr. Margolis' immediate career objectives include: (1) advanced course work in epidemiology, biostatistics, health services research, study design and analysis; (2) work with the Berman Center multi-center clinical trials and prospective studies; (3) work with mentor to develop and evaluate research direction, skills and experience; (4) obtain funding for and implement pilot and full-scale studies of randomized trial of physician incentives for improving the control of hypertension in a managed care organization; and (5) develop other related research projects. Dr. Margolis' long-term career objectives include attaining independence as an investigator in the field of patient-oriented cardiovascular disease prevention research and incorporating the theme of physician and patient adoption of effective interventions in a system of care for the prevention of cardiovascular disease morbidity and mortality. Research Plan. During the five year period of the award, Dr. Margolis plans to undertake at least one major clinical trial preceded by a pilot study for that trial. The clinical trial and pilot study are entitled "Program for Improving the Treatment and Control of Hypertension (PITCH)" and will involve testing the hypothesis that clinics in a managed care organization receiving funding to design their own program for improving the control of hypertension will have a higher percentage of hypertensives with controlled blood pressure compared to both clinics given similar funding for financial incentives (provided directly to physicians based on performance) and control clinics given no financial incentives. Dr. Margolis also has planned several other related projects which include: (1) study of patient attitudes towards physician financial incentives and satisfaction with care in PITCH; (2) study of impact of physician financial incentives in PITCH on medical care other than hypertension; and (3) the role of patient health state preferences in acceptance of hypertension treatment and control of hypertension.