Low-Density Lipoprotein Cholesterol Testing Following Myocardial Infarction Hospitalization Among Medicare...

Area of Science:

• Cardiovascular Medicine
• Health Services Research
• Public Health

Background:

• Low-density lipoprotein cholesterol (LDL-C) is crucial for guiding lipid-lowering therapy post-myocardial infarction (MI).
• Inadequate LDL-C testing after MI represents a significant missed opportunity for cardiovascular risk management.

Purpose of the Study:

• To determine the proportion of Medicare beneficiaries who underwent LDL-C testing within 90 days of MI hospital discharge.
• To analyze disparities in LDL-C testing rates across demographic groups and geographic regions.

Main Methods:

• Retrospective cohort study of Medicare beneficiaries aged 66+ with MI hospitalizations (2016-2020).
• Analysis included fee-for-service (FFS) beneficiaries with and without pharmacy benefits, and Medicare Advantage (MA) enrollees.
• LDL-C testing proportion was estimated using competing risk of death analysis.

Main Results:

• Only 29.9% of FFS beneficiaries with pharmacy benefits had LDL-C measured within 90 days post-MI.
• Testing rates varied by race/ethnicity (26.0% Black to 33.8% Hispanic) and region (23.4% West North Central to 36.4% Middle Atlantic).
• Rates were 26.9% for FFS without pharmacy benefits and 28.6% for MA enrollees.

Conclusions:

• LDL-C testing rates within 90 days post-MI discharge are low among Medicare beneficiaries.
• Suboptimal testing suggests a need for improved adherence to guidelines for cardiovascular risk management.