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

Litaker D, Koroukian S, Frolkis JP, Aron DC

Louis Stokes Cleveland Veterans Administration Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA. David.Litaker@med.va.gov

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.

Published 18 April 2006 in Prev Med, 42(4): 313-5.
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