Primary
Care Physicians Need to Improve Lipid Testing
for Patients With Diabetes
Over 2 years, 31% had no lipid profile and 24%
had only one lipid profile.
The object of the study was to identify factors
related to lipid testing among patients with diabetes
who receive diabetes care from primary care physicians.
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.
The results were 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.
From the results it was concluded that 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. Diabetes
Care 26:1369-1373, 2003
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