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APHA Scientific Session and Event Listing

Mangala Rajan, MBA, Anjali Tiwari, MSc, ChinLin Tseng, DrPH, Leonard Pogach, MD, PhD, and Usha Sambamoorthi, PhD. Center for Healthcare Knowledge Management, Department of Veterans Affairs, NJ Health Care System, 385 Tremont avenue, East Orange, NJ 07018, 973-676-1000 x2027, rajan@njneuromed.org

Objective: To evaluate the relationship of multiple cardiovascular conditions (CVC) on cardiovascular care (lipid (LDL-C) testing and control) among veteran women with CVC. The study also examined the interaction between major depression (MDD) and number of CVC on these outcomes.

Methods: VHA administrative data was used to identify a cohort of 39,558 veteran women with CVC (diabetes mellitus (DM), hypertension (HTN) or ischemic heart disease (IHD)), who were alive at the end of FY2000. ICD-9-CM codes were used to identify CVC and major depression (MDD) in FY1999. Control variables included age, race, and medicare enrollment. There were two outcome measures: presence of an LDL-C test and level of the first-recorded LDL-C in FY2000. Logistic and general linear regression models were used.

Results: 27% of women had DM, 22% had IHD and 85% had hypertension. 71% had any one of these three CVC's, 23.3% had any two, and 5.5% had all three; the percentage with an LDL-C test was 45%, 59% and 69% respectively(p<0.001). The mean LDL-C values for the three groups were 124, 116 and 110(p=<.0001). Higher number of CVC's was related to higher likelihood of LDL-C testing (p<0.001) and lower LDL values (p<0.001). Nearly a quarter (24%) of the cohort had MDD. However, there was no significant association between MDD and cardiovascular care.

Conclusions: More conditions were associated with better cardiovascular care among women with CVC's. The additional presence of MDD did not impact this relationship which suggests that it is not a particular barrier to cardiovascular care.

Learning Objectives:

• To identify chronic physical and mental conditions from administrative data
• To understand how comorbid mental and physical conditions affect chronic illness care

Keywords: Women's Health, Mental Health Care

Presenting author's disclosure statement:

Not Answered