Disparities among the disadvantaged: variation in lipid management in the Ohio Medicaid program.
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.
Litaker
David
D
Louis Stokes Cleveland Veterans Administration Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA. David.Litaker@med.va.gov
Koroukian
Siran
S
Frolkis
Joseph P
JP
Aron
David C
DC
D000328:Adult; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000191:economics / Q000208:ethnology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D009820:Ohio; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011203:Poverty / Q000208:ethnology; D015397:Program Evaluation; D012307:Risk Factors; D012923:Social Class; D012935:Social Justice; D012959:Socioeconomic Factors; D014481:United States; D035862:Vulnerable Populations / Q000208:ethnology*
D000960:Hypolipidemic Agents