Lipid Screening in a Managed Care Population

Objective: To determine the proportion of patients in a managed care setting who were screened and followed up for high blood cholesterol in accordance with the guidelines from the second report of the National Cholesterol Education Program-Adult Treatment Panel II. Methods: The authors conducted a retrospective review of the medical records of 1004 health plan members ages 40-64 who had been continuously enrolled over a period of five years at one of three Prudential Health-Care sites. Results: Eighty-four percent of patients in the study group had at least one total blood cholesterol level recorded in their medical records; a high density lipoprotein level was recorded for 67%. Cholesterol screening was highest among patients with a diagnosis of hypercholesterolemia (98%), hypertension (96%), or diabetes (94%) and among patients ages 60-64 (94%). Cholesterol screening did not vary by smoking status. More than 86% of those with a diagnosis of hypercholesterolemia were given dietary counseling, medication, or both. Conclusions: Compliance with national guidelines in this setting exceeded the Year 2000 goals for lipid management and was comparable with compliance reported in other settings. Routine surveillance of prevention efforts can be a useful way to assess quality of medical care in managed care organizations.