Sabatino Susan A, Thompson Trevor D, Guy Gery P, de Moor Janet S, Tangka Florence K
*Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA †Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.
Med Care. 2016 Apr;54(4):394-9. doi: 10.1097/MLR.0000000000000495.
We examined mammography use before and after Medicare eliminated cost sharing for screening mammography in January 2011.
Using National Health Interview Survey data, we examined changes in mammography use between 2010 and 2013 among Medicare beneficiaries aged 65-74 years. Logistic regression and predictive margins were used to examine changes in use after adjusting for covariates.
In 2013, 74.7% of women reported a mammogram within 2 years, a 3.5 percentage point increase (95% confidence interval, -0.3, 7.2) compared with 2010. Increases occurred among women aged 65-69 years, unmarried women, and women with usual sources of care and 2-5 physician visits in the prior year. After adjustment, mammography use increased in 2013 versus 2010 (74.8% vs. 71.3%, P=0.039). Interactions between year and income, insurance, race, or ethnicity were not significant.
There was a modest increase in mammography use from 2010 to 2013 among Medicare beneficiaries aged 65-74 years, possibly consistent with an effect of eliminating Medicare cost sharing during this time. Findings suggest that eliminating cost sharing might increase use of recommended screening services.
我们研究了2011年1月医疗保险取消乳腺X线筛查费用分担前后的乳腺X线检查使用情况。
利用国家健康访谈调查数据,我们研究了2010年至2013年期间65 - 74岁医疗保险受益人的乳腺X线检查使用情况变化。使用逻辑回归和预测边际来检验在调整协变量后使用情况的变化。
2013年,74.7%的女性报告在2年内进行了乳腺X线检查,与2010年相比增加了3.5个百分点(95%置信区间,-0.3, 7.2)。65 - 69岁的女性、未婚女性以及有常规医疗来源且上一年有2 - 5次看医生经历的女性的检查率有所增加。调整后,2013年与2010年相比乳腺X线检查使用率有所上升(74.8%对71.3%,P = 0.039)。年份与收入、保险、种族或族裔之间的交互作用不显著。
2010年至2013年期间,65 - 74岁医疗保险受益人的乳腺X线检查使用率有适度上升,这可能与在此期间取消医疗保险费用分担的影响一致。研究结果表明,取消费用分担可能会增加推荐筛查服务的使用。