Lipid Testing Among Patients With Diabetes Who Receive Diabetes Care From Primary Care Physicians
- Mark W. Massing, MD, PHD12,
- Nancy S. Henley, MPH, MD13,
- Lori Carter-Edwards, PHD24,
- Anna P. Schenck, PHD12 and
- Ross J. Simpson, Jr., MD, PHD13
- Medical Review of North Carolina, Cary, North Carolina
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina
- School of Medicine, University of North Carolina, Chapel Hill, North Carolina
- Rho, Chapel Hill, North Carolina
Abstract
OBJECTIVE—To identify factors related to lipid testing among patients with diabetes who receive diabetes care from primary care physicians.
RESEARCH DESIGN AND METHODS—North Carolina Medicare claims were used to identify individuals with diabetes who received diabetes care from primary care physicians. Lipid testing was related to sociodemographic characteristics, comorbid conditions, physician specialty, and mortality.
RESULTS—Based on Medicare claims from July 1997 through June 1999, 13,660 diabetic North Carolina residents with Medicare, 65–75 years of age, had received HbA1c testing from a single primary care physician during at least three of four consecutive 6-month time intervals. During these 2 years, 31% had no lipid profile and 24% had only one lipid profile. Caucasians were 1.6 times more likely than African Americans to receive lipid profiles. Patients not receiving state Medicare assistance were 1.4 times more likely to have a lipid profile than the presumably lower-income patients receiving assistance. Patients with stroke and heart failure were less likely to receive lipid profiles. Those with no lipid profile were almost twice as likely to die from cardiovascular disease than those with at least two lipid profiles.
CONCLUSIONS—Adherence to lipid testing recommendations by primary care physicians for elderly patients with diabetes has much room for improvement. The most vulnerable patients (African Americans, the economically disadvantaged, and the medically complex) are the least likely to receive lipid testing.
Footnotes
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Address correspondence and reprint requests to Mark W. Massing, MD, PhD, Medical Review of North Carolina, 5625 Dillard Dr., Cary, NC 27511. E-mail: mark_massing{at}unc.edu.
Received for publication 17 October 2002 and accepted in revised form 13 November 2002.
The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, and any mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. government.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
See accompanying editorial, p. 1633.
- DIABETES CARE
