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Hypertension Control Among Patients Receiving Care from a Field-Based Homeless Healthcare Team

Year: 2026

Type: article

Abstract: The UCLA Health Homeless Healthcare Collaborative (HHC) is a field-based homeless healthcare program that operates six mobile units staffed by clinicians, nurses, community health workers, and social workers across Los Angeles County. HHC provides primary care, urgent care, mental health care, and social services referrals to PEH at street encampments, shelters, motels, and pop-up events. We extracted electronic health record (EHR) data for patients 18 or older who had encounters with HHC between January 2022 and November 2025. We included patients if they had a diagnosis of hypertension based on International Classification of Diseases (ICD)-10 diagnostic code (I10 Essential Hypertension), were prescribed anti-hypertensives, or had a systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, in accordance with Healthcare Effectiveness Data and Information Set (HEDIS) specifications, on two outpatient encounters. We included patients with at least three documented clinical encounters with HHC. We included numerical blood pressure values and coded blood pressure control (systolic blood pressure < 140 and diastolic blood pressure < 90) per HEDIS. We also extracted demographic variables (age, sex, race, and ethnicity). Changes between the first and most recent blood pressure values recorded by HHC were compared using a paired t -test. McNemar’s exact test was used to compare blood pressure control between the first and most recent blood pressures. Among 887 adults in the hypertension cohort, the mean age was 55.1; 624 (70.4%) participants were male; 199 (22.4%) identified as Hispanic, 186 (21.0%) as non-Hispanic Black, 175 (19.7%) as non-Hispanic White, and 25 (2.8%) as Other; and 284 (32.0%) had missing race and ethnicity data (Table 1 ). The hypertension cohort had a median of five encounters with HHC (interquartile range (IQR) 4–9) and median follow-up time of 238 days between T 0 and T 1 . Patients’ mean systolic blood pressure decreased from 146.2 mmHg (SD 23.1) at T 0 to 141.0 mmHg (SD 22.5) at T 1 ( p < 0.001), while mean diastolic blood pressure decreased from 87.4 (SD 13.8) at T 0 to 84.6 mmHg (SD 12.8) at T 1 ( p < 0.001) (Fig. 1 ). The number of patients with hypertension control increased from 308 (34.7%) at T 0 to 402 (45.3%) at T 1 ( p < 0.001). Sensitivity analyses among patients prescribed anti-hypertensives showed similar results (results not shown). Blood pressure at baseline (pre) and most recent (post) values among Homeless Healthcare Collaborative (HHC) patients with hypertension, and overlying box and whisker plots. *** denotes p < 0.001. P -values derived from paired t -test. Abbreviations: DBP, diastolic blood pressure; mmHg, millimeters of mercury; SBP, systolic blood pressure.

Source: Journal of General Internal Medicine

DOI: 10.1007/s11606-026-10488-2