Physicians' behavior following changes in LDL cholesterol target goals

Shlomo Vinker, Haim Bitterman, Doron Comaneshter, Arnon D. Cohen

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: In 01/2011 Clalit Health Services (CHS), changed the LDL-Cholesterol target definitions in its quality indicators program, from a universal target to values stratified by risk assessment based on ATP III criteria. The objective of this study is to evaluate the effect of this change on achievement of LDL-C targets and on physicians' prescriptions of statins. Methods: Setting: CHS, The largest health maintenance organization in Israel that insures above 4,000,000 beneficiaries. Results: 433,662 patients remained in the same risk groups throughout the study period; 55.8% were women; the average age was 53.0 ± 10.3 years; 63.9%, 13.4%, and 22.7% were at low, medium, and high risk respectively. After implementation, the proportion of patients reaching LDL-C targets increased in all risk groups: from 58.6% to 61.6%, from 55.1% to 61.1%, and from 44.5% to 49.0%, in low, medium, and high risk groups respectively (p < 0.001). The proportion of patients treated with potent statins increased in all risk groups; from 3.4% to 5.6%, from 6.7% to 10.3%, and from 14.5% to 20.3% respectively (p < 0.001). Conclusion: The risk stratification approach as a basis for the quality indicators program was implemented and better achievement of target LDL-C levels ensued. We suggest that implementation of quality indicators that are consistent with the current literature can lead to improvements that exceeds temporal trends.

Original languageEnglish
Article number20
JournalIsrael Journal of Health Policy Research
Volume4
Issue number1
DOIs
StatePublished - 1 Jun 2015

Keywords

  • Clinical guidelines
  • Hypercholesterolemia
  • Quality indicators
  • Statins

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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