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Lipid Testing among Youth in Medicaid: The Role of Social Determinants of Health and Providers.
Huo, Tianyao; Cardel, Michelle I; Thompson, Lindsay A; Lemas, Dominick J; Pearson, Thomas A; Gurka, Matthew J.
Afiliación
  • Huo T; IQVIA, Inc., Wayne, PA; Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL.
  • Cardel MI; Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL; WW International, Inc., New York, NY.
  • Thompson LA; Department of Pediatrics, Wake Forest University, Raleigh, NC.
  • Lemas DJ; Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL.
  • Pearson TA; Department of Epidemiology, University of Florida, Gainesville, FL.
  • Gurka MJ; University of Virginia, Charlottesville, VA. Electronic address: mgurka@virginia.edu.
J Pediatr ; 274: 114170, 2024 Nov.
Article en En | MEDLINE | ID: mdl-38944189
ABSTRACT

OBJECTIVE:

To assess recent temporal trends in guideline-compliant pediatric lipid testing, and to examine the influence of social determinants of health (SDoH) and provider characteristics on the likelihood of testing in youth. STUDY

DESIGN:

In this observational, multiyear cross-sectional study, we calculated lipid testing prevalence by year among 268 627 12-year olds from 2015 through 2019 who were enrolled in Florida Medicaid and eligible for universal lipid screening during age 9 to 11, and 11 437 22-year olds (2017-2019) who were eligible for screening during age 17-21. We compared trends in testing prevalence by SDoH and health risk factors at two recommended ages and modeled the associations between patient characteristics and provider type on lipid testing using generalized estimating equations.

RESULTS:

Testing among 12-year olds remained low between 2015 through 2019 with the highest prevalence in 2015 (8.0%) and lowest in 2017 (6.7%). Screening compliance among 22-year olds was highest in 2017 (21.1%) and fell to 17.8% in 2019. Hispanics and non-Hispanic Blacks in both age groups had about 2%-3% lower testing prevalence than non-Hispanic Whites. Testing in 12-year olds was 12.3% vs 7.7% with and without obesity, and 14.4% vs 7.6% with and without antipsychotic use. Participants who saw providers who were more likely to prescribe lipid testing were more likely to receive testing (OR = 2.3, 95% CI 2.0-2.8, P < .001).

CONCLUSIONS:

Although lipid testing prevalence was greatest among high-risk children, overall prevalence of lipid testing in youth remains very low. Provider specialty and choices by individual providers play important roles in improving guideline-compliant pediatric lipid testing.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / Determinantes Sociales de la Salud Límite: Adolescent / Adult / Child / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / Determinantes Sociales de la Salud Límite: Adolescent / Adult / Child / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos