Disparities among the disadvantaged: variation in lipid management in the Ohio Medicaid program

Prev Med. 2006 Apr;42(4):313-5. doi: 10.1016/j.ypmed.2005.11.016. Epub 2006 Jan 6.

Abstract

Background: Racial disparities exist in cardiovascular disease (CVD) prevention, but other non-clinical factors may influence treatment, further exacerbating disparities.

Methods: Using Ohio Medicaid data from 1992 to 1999, we identified a sample of 19,106 individuals with CVD-related diagnoses or procedures. A review of pharmacy claims identified previous, new, and long-term users of lipid-lowering agents, including statins, fibrates, and bile sequestrants.

Results: 3,934 (20.6%) Medicaid beneficiaries used lipid-lowering medications previously, 1,598 (10.5%) filed new claims, and 2,998 of 5,532 (54.2%) previous or new users filed >or=6 claims for refills. Minority adults <or=60 years were least likely to have been previous users (0.80 [0.67, 0.96]), new users (0.75 [0.58, 0.98]), or to use lipid-lowering agents long-term (0.65 [0.49, 0.84]).

Conclusions: Targeted efforts to enhance younger minority adults' receipt and long-term use of lipid-lowering agents may reduce risks for subsequent morbidity and mortality related to CVD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / prevention & control*
  • Female
  • Health Services Accessibility*
  • Humans
  • Hyperlipidemias / drug therapy*
  • Hyperlipidemias / economics
  • Hyperlipidemias / ethnology
  • Hypolipidemic Agents / therapeutic use*
  • Male
  • Medicaid / statistics & numerical data*
  • Middle Aged
  • Ohio
  • Patient Acceptance of Health Care / ethnology*
  • Poverty / ethnology
  • Program Evaluation
  • Risk Factors
  • Social Class*
  • Social Justice*
  • Socioeconomic Factors
  • United States
  • Vulnerable Populations / ethnology*

Substances

  • Hypolipidemic Agents