Abstract
Objectives: Cardiometabolic risk (CMR) is the overall risk of developing diabetes and/or cardiovascular disease due to a cluster of modifiable risk factors. CMR has been defined in a variety of ways, but all definitions include some combination of abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. This retrospective study was conducted to (1) determine the prevalence of these CMR factors among female health plan members, identifying differences by ethnicity status (Hispanic vs non-Hispanic); and (2) quantify differences in 2-year healthcare utilization between cohorts of individuals with CMR versus controls without CMR.
Methods: The study consisted of 2578 female members (27.6% Hispanic) of a southwestern US HMO who had a bone mineral density test during 2003–2004. This population was selected since these patients had, in addition to their bone scan results, a measure of height and weight, allowing us to calculate BMI. The following risk factors were used to define CMR: obesity (BMI >27 kg/m2), high triglycerides (>150 mg/dL), low HDL cholesterol (<50 mg/dL), high blood pressure (systolic >130 mm Hg or diastolic >85 mm Hg), and high fasting glucose (>100 mg/dL).
Results: Results showed that Hispanic females had significantly higher prevalence rates of CMR compared to non-Hispanic females (65.8% vs 52.3%, respectively, P<0.001). Patients with CMR factors were more likely than controls to have at least one hospitalization (P<0.05). Outpatient visit rates and total costs were higher than controls, particularly for those patients with a diabetes diagnosis. Patients with obesity and diabetes and patients with obesity, diabetes, and dyslipidemia averaged approximately 34 visits vs approximately 22 visits for their respective controls (P<0.01). Total costs were about $11,500 for those cases with diabetes vs $5,500 for controls. Total costs for all CMR cases were about $7,000 vs $5,500 for controls.
Conclusions: Higher rates of CMR among female Hispanics compared to female non-Hispanics are consistent with earlier studies. The higher utilization for those with CMR suggests the need for health maintenance organizations to identify and monitor health plan members with CMR. Future research should explore cultural diversity as it relates to CMR, including differences between Hispanics and non-Hispanics in access to care and disease management programs.
- Received September 11, 2008.
