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In the second article Millet and colleagues found differences in prescribing medication and blood pressure control among ethnic groups in England despite major investments in quality improvement initiatives , and a health system that provides universal access. The researchers analyzed data from 8876 patients from general practices in southwest London after the implementation of a major pay – for-performance program that placed great emphasis on improving the quality of care for people with cardiovascular disease. They found black patients with hypertension had significantly higher mean blood pressure and significantly less an established treatment an established treatment target for blood pressure control to achieve than white or South Asian patients. Furthermore, they found differences were particularly marked among patients with multiple cardiovascular diseases, which may well be the sickest patients. They conclude that large-scale quality improvement programs may components components in order to improve the quality of care for high-risk individuals, including those from ethnic minorities. Continue reading