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.