UC Irvine

Objective

Evaluate utilization and diagnosis rates in a self-pay, self-referred screening program for dyslipidemia.

Design

301 patients self-referred to the clinical laboratory for lipid testing in a two-year period. The patient population that participated was characterized in terms of insurance status, gender, age, and known cardiovascular risk factors. Lipid profiles were characterized as measured by total cholesterol, triglycerides (TGs), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and total cholesterol to HDL risk factor.

Setting

Clinical laboratory in an academic medical center.

Patients

Data from all patients that self-selected for screening were included.

Interventions

Immediate laboratory results with both verbal and written interpretations and recommendations were provided to the patients.

Main outcome measures

Age, gender, insurance status, number of known risk factors, and lipid profiles in the subject group.

Results

The mean age of participants was 57 years. Men (197) outnumbered women (104) by almost 2:1; most (94%) had health insurance. At presentation, 44% of the patients had more than one risk factor for coronary heart disease (CHD). 151 individuals (50%) had lipid findings that would require at least dietary intervention by NCEP guidelines.

Conclusion

A self-pay, self-referred screening program for lipid disorders is an effective means of improving screening and diagnosis rates. Patients with insurance were willing to pay for the convenience offered and men in particular were more likely to self-refer than women, independent of previous knowledge of risk factors or lipid disorders.