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Gender disparities in cardiovascular disease care among commercial and medicare managed care plans.
Womens Health Issues. 2007 May-Jun; 17(3):139-49.WH

Abstract

BACKGROUND

Gender disparities in cardiovascular care have been documented in studies of patients, but little is known about whether these disparities persist among managed health care plans. This study examined 1) the feasibility of gender-stratified quality of care reporting by commercial and Medicare health plans; 2) possible gender differences in performance on prevention and treatment of cardiovascular disease in US health plans; and 3) factors that may contribute to disparities as well as potential opportunities for closing the disparity gap.

METHODS

We evaluated plan-level performance on Healthcare Effectiveness Data and Information Set (HEDIS) measures using a national sample of commercial health plans that voluntarily reported gender-stratified data and for all Medicare plans with valid member-level data that allowed the computation of gender-stratified performance data. Key informant interviews were conducted with a subset of commercial plans. Participating commercial plans in this study tended to be larger and higher performing than other plans who routinely report on HEDIS performance.

RESULTS

Nearly all Medicare and commercial plans had sufficient numbers of eligible members to allow for stable reporting of gender-stratified performance rates for diabetes and hypertension, but fewer commercial plans were able to report gender-stratified data on measures where eligibility was based on recent cardiac events. Over half of participating commercial plans showed a disparity of >/=5% in favor of men for cholesterol control measures among persons with diabetes and persons with a recent cardiovascular procedure or heart attack, whereas no commercial plans showed such disparities in favor of women. These gender differences favoring men were even larger for Medicare plans, and disparities were not linked to health plan performance or region.

CONCLUSIONS AND DISCUSSION

Eliminating gender disparities in selected cardiovascular disease preventive quality of care measures has the potential to reduce major cardiac events including death by 4,785-10,170 per year among persons enrolled in US health plans. Health plans should be encouraged to collect and monitor quality of care data for cardiovascular disease for men and women separately as a focus for quality improvement.

Authors+Show Affiliations

Department of Health Administration and Policy, College of Public Health and College of Medicine, University of Oklahoma, 801 NE 13th Street, Oklahoma City, OK 73120, USA. ann-chou@ouhsc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17481918

Citation

Chou, Ann F., et al. "Gender Disparities in Cardiovascular Disease Care Among Commercial and Medicare Managed Care Plans." Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, vol. 17, no. 3, 2007, pp. 139-49.
Chou AF, Wong L, Weisman CS, et al. Gender disparities in cardiovascular disease care among commercial and medicare managed care plans. Womens Health Issues. 2007;17(3):139-49.
Chou, A. F., Wong, L., Weisman, C. S., Chan, S., Bierman, A. S., Correa-de-Araujo, R., & Scholle, S. H. (2007). Gender disparities in cardiovascular disease care among commercial and medicare managed care plans. Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, 17(3), 139-49.
Chou AF, et al. Gender Disparities in Cardiovascular Disease Care Among Commercial and Medicare Managed Care Plans. Womens Health Issues. 2007 May-Jun;17(3):139-49. PubMed PMID: 17481918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gender disparities in cardiovascular disease care among commercial and medicare managed care plans. AU - Chou,Ann F, AU - Wong,Lok, AU - Weisman,Carol S, AU - Chan,Sophia, AU - Bierman,Arlene S, AU - Correa-de-Araujo,Rosaly, AU - Scholle,Sarah Hudson, Y1 - 2007/05/03/ PY - 2007/01/12/received PY - 2007/03/22/revised PY - 2007/03/22/accepted PY - 2007/5/8/pubmed PY - 2007/8/1/medline PY - 2007/5/8/entrez SP - 139 EP - 49 JF - Women's health issues : official publication of the Jacobs Institute of Women's Health JO - Womens Health Issues VL - 17 IS - 3 N2 - BACKGROUND: Gender disparities in cardiovascular care have been documented in studies of patients, but little is known about whether these disparities persist among managed health care plans. This study examined 1) the feasibility of gender-stratified quality of care reporting by commercial and Medicare health plans; 2) possible gender differences in performance on prevention and treatment of cardiovascular disease in US health plans; and 3) factors that may contribute to disparities as well as potential opportunities for closing the disparity gap. METHODS: We evaluated plan-level performance on Healthcare Effectiveness Data and Information Set (HEDIS) measures using a national sample of commercial health plans that voluntarily reported gender-stratified data and for all Medicare plans with valid member-level data that allowed the computation of gender-stratified performance data. Key informant interviews were conducted with a subset of commercial plans. Participating commercial plans in this study tended to be larger and higher performing than other plans who routinely report on HEDIS performance. RESULTS: Nearly all Medicare and commercial plans had sufficient numbers of eligible members to allow for stable reporting of gender-stratified performance rates for diabetes and hypertension, but fewer commercial plans were able to report gender-stratified data on measures where eligibility was based on recent cardiac events. Over half of participating commercial plans showed a disparity of >/=5% in favor of men for cholesterol control measures among persons with diabetes and persons with a recent cardiovascular procedure or heart attack, whereas no commercial plans showed such disparities in favor of women. These gender differences favoring men were even larger for Medicare plans, and disparities were not linked to health plan performance or region. CONCLUSIONS AND DISCUSSION: Eliminating gender disparities in selected cardiovascular disease preventive quality of care measures has the potential to reduce major cardiac events including death by 4,785-10,170 per year among persons enrolled in US health plans. Health plans should be encouraged to collect and monitor quality of care data for cardiovascular disease for men and women separately as a focus for quality improvement. SN - 1049-3867 UR - https://www.unboundmedicine.com/medline/citation/17481918/Gender_disparities_in_cardiovascular_disease_care_among_commercial_and_medicare_managed_care_plans_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1049-3867(07)00055-2 DB - PRIME DP - Unbound Medicine ER -