医疗保险覆盖范围在癌症筛查利用方面的作用。
The role of health insurance coverage in cancer screening utilization.
作者信息
Robinson JaMuir M, Shavers Vickie
机构信息
Cancer Prevention and Fellowship Program, Division of Cancer Prevention and Office of Education and Special Initiatives, National Cancer Institute, 6116 Executive Blvd., Ste. 202, Bethesda, MD 20892, USA.
出版信息
J Health Care Poor Underserved. 2008 Aug;19(3):842-56. doi: 10.1353/hpu.0.0048.
INTRODUCTION
Although previous studies have shown a correlation between health insurance coverage and cancer screening, underinsurance and cancer screening among racial/ethnic minorities has not been examined.
METHODS
Data from the 2000 and 2003 National Health Interview Surveys are used in this analysis. Cross-tabulations, age, and racial/ethnic group stratified regression analyses are used to examine associations between health insurance status and receipt of mammography, Pap testing, prostate specific antigen tests, fecal occult blood test (FOBT) and colorectal endoscopy.
RESULTS
In overall models, uninsurance was associated with lower receipt of all tests except FOBT among participants ages 65-85 years. Underinsurance was associated with lower receipt of mammography among women under 65 years only.
CONCLUSION
These findings show age variation in the association between cancer screening and health insurance coverage. In addition, health insurance appears to act similarly across racial/ethnic groups. Further examination of underinsurance in cancer screening utilization and other health behaviors is needed.
引言
尽管先前的研究表明医疗保险覆盖范围与癌症筛查之间存在关联,但种族/族裔少数群体中的保险不足与癌症筛查情况尚未得到研究。
方法
本分析使用了2000年和2003年全国健康访谈调查的数据。采用交叉表、年龄以及种族/族裔群体分层回归分析来研究医疗保险状况与接受乳房X光检查、巴氏试验、前列腺特异性抗原检测、粪便潜血试验(FOBT)和大肠内窥镜检查之间的关联。
结果
在总体模型中,65至85岁的参与者中,未参保与除FOBT外所有检查的接受率较低有关。仅在65岁以下女性中,保险不足与乳房X光检查的接受率较低有关。
结论
这些发现表明癌症筛查与医疗保险覆盖范围之间的关联存在年龄差异。此外,医疗保险在不同种族/族裔群体中的作用似乎相似。需要进一步研究癌症筛查利用和其他健康行为中的保险不足情况。