The Role of Usual Source of Care in Cholesterol Treatment

Paul Winters; Daniel Tancredi; Kevin Fiscella

doi:10.3122/jabfm.2010.02.090084

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Table 1.

Characteristics of Adults in the National Health and Nutrition Examination Survey (n = 12,979) 1999 to 2006 Sample by Usual Source of Care²¹

Descriptive Variable	Total (%)	Percentage by Usual Source of Care		P
Descriptive Variable	Total (%)	No	Yes	P
Total	100	17.9	82.1
Age (years)				<.0001
21–34	30.5	49.4	26.3
35–44	24.4	23.7	24.5
45–54	22.2	17.7	23.1
55–64	12.2	6.2	13.5
>65	10.9	3	12.6
Male	48	67.2	43.8	<.0001
Race/ethnicity				<.0001
Hispanic	12.7	23.1	10.4
White	72.2	59.4	75
Black	10.3	11.2	10.1
Other	4.8	6.3	4.5
Federal poverty level (%)			<.0001
<100	11.5	18.2	10
100–199	19.1	26.8	17.5
200–299	15.9	17.3	15.6
300–499	26.8	21.6	28
>500	26.6	16.1	29
Education (years)				<.0001
<12	17.1	26.4	15
12	25	26.7	24.6
>12	57.9	46.8	60.3
No insurance	18.2	46.9	11.9	<.0001
Physician visits				<.0001
0	17.2	46.7	10.8
1	21.6	25	20.8
2–3	27.3	15.9	29.8
4–9	21.6	7.8	24.6
10 to 12	5.5	1.8	6.3
≥13	6.8	2.8	7.7
Prefer English language	90.6	81.2	92.7	<.00001
CHD 10-year risk (%)				<.00001
<10	83.7	87.9	82.8
10–20	15	11.4	15.7
>20	1.3	0.7	1.5
Taking statin	5.35	0.9	6.3	<.0001

All results based on population weights.
CHD, coronary heart disease.
Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey Data. Available at http://www.cdc.gov/nchs/surveys.htm.

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Table 2.

Use of Statins among Eligible Adults (n = 1927) in the National Health and Nutrition Examination Survey, 1999 to 2006²¹

Predictor Variable	Odds Ratio (95% CI)
Survey year
1999–2000	1.00 (1.00–1.00)
2001–2002	1.87 (1.03–3.39)
2003–2004	5.63 (3.54–8.95)
2005–2006	6.36 (3.83–10.55)
Usual source of care
No	1.00 (1.00–1.00)
Yes	4.64 (2.14–10.04)
Age (years)
21–34	1.00 (1.00–1.00)
35–44	14.80 (3.25–67.41)
45–54	21.42 (4.91–93.29)
55–64	28.67 (6.73–122.12)
≥65	35.86 (8.24–156.15)
Sex
Female	1.00 (1.00–1.00)
Male	0.87 (0.67–1.12)
Race/ethnicity
Hispanic	0.81 (0.42–1.55)
Non-Hispanic white	1.00 (1.00–1.00)
Non-Hispanic black	0.93 (0.64–1.34)
Other	1.15 (0.58–2.30)
Federal poverty level (%)
<100	0.98 (0.48–2.00)
100–199	1.01 (0.57–1.80)
200–299	0.99 (0.60–1.64)
300–499	0.97 (0.58–1.60)
>500	1.00 (1.00–1.00)
Education (years)
>12	0.77 (0.45–1.30)
12	1.07 (0.77–1.47)
<12	1.00 (1.00–1.00)
Preferred language
English	1.00 (1.00–1.00)
Other	0.87 (0.47–1.63)
Health insurance coverage
No	1.00 (1.00–1.00)
Yes	1.98 (0.96–4.12)

All results have been adjusted for insurance, language, usual source of care, and survey year.
Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey Data. Available at http://www.cdc.gov/nchs/surveys.htm.

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Table 3.

Predictors of Low-Density Lipoprotein Cholesterol Goal Attainment among Adults (n = 1,133) Taking Statins in the National Health and Nutrition Examination Survey, 1999 to 2006²¹

Predictor Variable	Odds Ratio (95% CI)
Survey year
1999–2000	1.00 (1.00–1.00)
2001–2002	2.27 (1.12–4.59)
2003–2004	2.92 (1.65–5.18)
2005–2006	3.81 (2.07–6.99)
Usual source of care
No	2.04 (0.91–4.54)
Yes	1.00 (1.00–1.00)
Age (years)
21–34	1.00 (1.00–1.00)
35–44	0.24 (0.03–2.21)
45–54	0.33 (0.03–3.27)
55–64	0.25 (0.03–2.34)
≥65	0.37 (0.04–3.24)
Sex
Female	1.00 (1.00–1.00)
Male	0.74 (0.51–1.06)
Race/ethnicity
Hispanic	0.73 (0.39–1.36)
Non-Hispanic white	1.00 (1.00–1.00)
Non-Hispanic black	0.89 (0.60–1.32)
Other	0.72 (0.32–1.65)
Federal poverty level (%)
<100	0.42 (0.22–0.80)
100–199	0.59 (0.37–0.93)
200–299	1.00 (1.00–1.00)
300–499	0.87 (0.52–1.45)
>500	1.00 (1.00–1.00)
Education (years)
<12	0.59 (0.41–0.86)
12	0.82 (0.56–1.20)
>12	1.00 (1.00–1.00)
Preferred language
English	1.00 (1.00–1.00)
Other	1.51 (0.72–3.17)
Health insurance coverage
No	1.76 (0.65–4.75)
Yes	1.00 (1.00–1.00)

All results have been adjusted for insurance, language, usual source of care, and survey year.
Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey Data. Available at http://www.cdc.gov/nchs/surveys.htm.