Factors Associated with Potentially Inappropriate Screening for Vitamin D Deficiency among Women in Medically Underserved Regions of West Texas

Abstract

Testing for vitamin D deficiency (VDD) has been on the increase due to its association with several diseases. However, inappropriate testing for VDD, defined as screening for VDD among individuals with a low risk, has been reported. The aim of this study was to evaluate the prevalence and factors associated with potentially inappropriate screening for VDD among medically underserved populations in West Texas. Data were from 21,407 women who were hospitalized from 2016 to 2018 at a large regional health system. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). The median age of patients was 40 years. While the proportion of patients tested for VDD reduced from 8.9% to 7.6% (p = 0.013) from 2016 to 2018, the prevalence of inappropriate testing increased from 32.3% to 46.8% (p < 0.001), with the 3-year prevalence of VDD being 27.6%. White race (OR = 2.71, CI: 1.95–3.78), an age ≥ 65 years (OR = 3.07, CI: 2.05–4.59), the use of public-sponsored insurance (OR = 1.62, CI: 1.20–2.17), cardiovascular disease (OR = 0.75, CI: 0.63–0.90), and vitamin D supplement use (OR = 7.05, CI: 5.82–8.54) were associated with inappropriate testing for VDD. In this study, an increasing prevalence of potentially inappropriate testing for VDD was observed. Sociodemographic and health-related conditions were associated with potentially inappropriate testing for VDD.

Keywords

• vitamin D
• women
• medical overuse
• vitamin D deficiency
• medically underserved area
• Texas