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Ann F. Chou, PhD, MPH Carol S. Weisman, PhD Rosaly Correa-de-Araujo, MD, PhD

Investigating Gender Differences in HEDIS Measures Related to Heart Disease. Ann F. Chou, PhD, MPH Carol S. Weisman, PhD Rosaly Correa-de-Araujo, MD, PhD Sarah H. Scholle, DrPH, MPH. Background.

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Ann F. Chou, PhD, MPH Carol S. Weisman, PhD Rosaly Correa-de-Araujo, MD, PhD

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  1. Investigating Gender Differences in HEDIS Measures Related to Heart Disease Ann F. Chou, PhD, MPH Carol S. Weisman, PhD Rosaly Correa-de-Araujo, MD, PhD Sarah H. Scholle, DrPH, MPH

  2. Background • Substantial literature documents gender disparities in guideline-indicated preventive and treatment services related to cardiovascular disease (CVD). • Women may need more aggressive risk factor management than men due to differences in risk factors and symptom presentation.

  3. CVD in Managed Care Population • A significant portion of the US population receives care through managed care organizations, where the quality of care may be more uniform. • Few studies that examined gender disparities in CVD-related care among managed care enrollees.

  4. Study Objectives • To assess the reportability of CVD measures by gender (under existing specifications) • To determine whether gender disparities in performance were evident within health plans

  5. CVD-related HEDIS Measures • Beta blocker treatment post acute myocardial infarction (AMI) • Persistence of beta blocker treatment post AMI • Controlling high blood pressure • Comprehensive diabetes care: • Cholesterol screening • LDL control <100 mg/dL • Cholesterol management after acute cardiovascular event: • Cholesterol screening • LDL control <100 mg/dL

  6. NCQA Sample Recruitment • 289 Plans, varied by measure, that submit 2005 HEDIS performance data to NCQA were invited to participate in feasibility test. • The final sample included 46 commercial health Plans, representing a national sample.

  7. Plans in Study Profit status For profit: 33 (73.3%) Not for profit: 12 (26.7%) Model type Group: 2 (4.4%) IPA/Network: 25 (54.4%) Mixed Model: 19 (41.3%) Size* <95,000 members: 16 (34.8%) 95,000+: 30 (65.2%) All Others Reporting HEDIS Profit status For profit: 169 (72.2%) Not for profit: 65 (27.8%) Model type Group: 10 (4.1%) IPA/Network: 114 (46.9%) Mixed Model: 119 (49.0%) Size <95,000 members: 141 (58.0%) 95,000+: 102 (42.0%) Participating Plan Characteristics

  8. Comparing Performance of Plans in Study v. All Other HEDIS-reporting Plans

  9. Descriptive statistics Calculation of disparities score (male-female difference) T- and chi-square tests to determine significance of the gender difference Methods

  10. Sample and Reportability of Gender Stratified Data

  11. Performance Rates by Gender

  12. Distribution of Disparity Scores

  13. Magnitude of Gender Disparities

  14. Conclusion • Reporting of CVD measures based on gender is feasible for most measures. • Differences in plan performance by gender were noted for 3 of the 7 CVD measures.

  15. Discussion • The CVD measures demonstrated a large range in disparity score among plans. LDL control for those with a history of CVD ranged from 3.4 in favor of women to 31.8 in favor of men in commercial plans. • Denominator size limited adequate assessment for several CVD measures.

  16. Implications • Consumers/patients • Providers • Health plans

  17. Acknowledgements • The Agency for Healthcare Research and Quality and the American Heart Association provided funding support for this research. • NCQA staff provided data management and administrative support.

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