Ischemic heart disease is a major health problem in the United States where secondary prevention therapies have been demonstrated to improve morbidity and mortality. Multiple guidelines have been published which recommend cholesterol lowering for patients with ischemic heart disease. Despite these recommendations, wide variations exist in the achievement of these target LDL levels. The purpose of the current project is to identify patient characteristics, processes of care and structures of care that are associated with these variations in compliance of target LDL levels. A cross-sectional study design will be used. Information will be gathered from secondary data sources, using the Veterans Health Administration databases and through primary data collection, by surveying care providers. Thirty clinics or facilities and approximately 10, 000 patients will be included in the sample. Once identified, these factors can serve as the focus for future quality improvement projects to increase the proportion of ischemic heart disease patients who achieve a target LDL-cholesterol level of less than or equal to 100 mg/dl as proposed in the Healthy People objectives.
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