No Level Playing Field for Women in Routine, Low-Tech Care of Two Major Killers

SANTA MONICA, Calif., May 14 -- Women are less likely to achieve good control of both heart disease and diabetes than men because they get lower quality care, researchers here reported.

Diabetic women enrolled in Medicare managed care plans were 19% less likely to achieve LDL control compared with men and women enrolled in commercial managed care plans were about 16% less likely to have cholesterol under control, according to a RAND study published in the May/June issue of the journal Women's Health Issues.

The authors used Health Employer Data and Information Set (HEDIS) measures to assess quality of care for patients enrolled in 10 commercial managed care plans and nine Medicare plans.

Chloe E. Bird, Ph.D., a RAND sociologist, and colleagues tracked 11 measures:

• beta-blocker use after myocardial infarction,
• LDL screening after a cardiovascular event,
• LDL cholesterol control after a cardiovascular event,
• use of an angiotensin-converting enzyme inhibitor in patients with congestive heart failure,
• blood pressure control in hypertensives,
• glycosylated hemoglobin check in diabetics,
• glycosylated hemoglobin control in diabetics,
• LDL control in diabetics,
• LDL screening in diabetics,
• nephropathy check in diabetics,
• eye exam in diabetics.

The researchers analyzed 1999 claims data from 15,252 Medicare patients and 34,981 patients with commercial health coverage. Fifty-three percent of the Medicare patients and 45% of the commercial plan patients were women.

Among the findings:

• Among diabetic Medicare enrollees, only 33.4% of women had LDL-C controlled to goal compared with 41.3% of men (P