Is the Type of Medicare Insurance Associated With Colorectal Cancer Screening Prevalence and Selection of Screening Strategy
Bibliographic Data
| ID | 9097802 |
|---|---|
| Authors | Eric C Schneider (0000-0002-1132-5084, Harvard University, corresponding author), Meredith Rosenthal, Meredith B Rosenthal (0000-0003-3410-0184, corresponding author), Constantine Gatsonis (0000-0001-6846-4520), Constantine G Gatsonis, Jie Zheng (0009-0002-7853-6721, corresponding author), Arnold M Epstein (0000-0003-2374-0311, Brigham and Women's Hospital, corresponding author) |
| Year | 2008 |
| Volume | 46 |
| Issue | 9 |
| Pages | S84-S90 |
| Publication date | 2008-09-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e31817fdf80 |
| PMID | 18725838 |
| OpenAlex | W2058920335 |
| Language | EN |
| Citations received | 4 |
| References cited | 26 |
BACKGROUND: Medicare managed care (MMC) plans may be better positioned to deliver preventive services than fee-for-service (FFS) insurers. We assessed whether beneficiaries in MMC plans were more likely than those in traditional FFS insurance to receive colorectal cancer (CRC) screening and whether type of insurance was associated with use of specific screening strategies. METHODS: We studied 10,173 respondents to the 2000 Medicare Current Beneficiary Survey representing 24,394,204 US Medicare beneficiaries. We identified 4 CRC screening strategies: (1) interval-appropriate screening, (2) fecal occult blood testing (FOBT) within the past 2 years, (3) colonoscopy or sigmoidoscopy within the past 5 years, and (4) primary invasive screening (interval-appropriate colonoscopy or sigmoidoscopy without FOBT). Using a propensity score model to adjust for the nonrandom selection of insurance based on sociodemographic characteristics and other respondent-reported "care-seeking" variables, we compared the adjusted percentage of MMC and FFS beneficiaries screened using each CRC screening strategy. RESULTS: In this sample, 21.6% of Medicare beneficiaries were continuously enrolled in MMC, 61.3% had FFS with supplemental insurance, and 17.1% had FFS coverage alone. Just over 51% of beneficiaries received interval-appropriate CRC screening. Interval-appropriate CRC screening was reported by 54.7% in FFS with supplemental insurance, 52.9% in MMC, and 36.3.% in the FFS group without supplemental insurance (P < 0.001). Use of the FOBT strategy was more common in MMC compared with FFS with or without supplemental insurance. Adjustment for sociodemographic characteristics and care-seeking propensity had a sizable impact on differences in screening prevalence, but did not substantially alter the conclusions. CONCLUSIONS: In 2000, the type of Medicare insurance was associated with differences in the prevalence of interval-appropriate CRC screening with lower prevalence among FFS beneficiaries who lacked supplemental insurance. Although managed care did not produce more CRC screening than supplemental insurance, managed care plans seem to have encouraged FOBT testing over other strategies
Cancer · Colonoscopy · Colorectal cancer · Confidence interval · Family medicine · Fecal occult blood · Propensity score matching · Sigmoidoscopy · Colorectal Cancer Screening and Detection · Global Cancer Incidence and Screening · Healthcare Policy and Management · Internal Medicine · Medicine
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Self‐Reported Cancer Screening Among Elderly Medicare Beneficiaries
Innovative Provider- and Health System-Directed Approaches to Improving Colorectal Cancer Screening Delivery
Improving Colorectal Cancer Screening Through Research in Primary Care Settings
Unmet Health Needs of Uninsured Adults in the United States
Estimating Causal Effects from Large Data Sets Using Propensity Scores
Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group
Barriers to Colorectal Cancer Screening
Preventive Services Among Medicare Beneficiaries With Supplemental Coverage Versus HMO Enrollees, Medicaid Recipients, and Elders With No Additional Coverage
Effect of Managed Care Insurance on the Use of Preventive Care for Specific Ethnic Groups in the United States
The Association Between Health Care Coverage and the Use of Cancer Screening Tests
Type of Health Care Coverage and the Likelihood of Being Screened for Cancer
| Unique citing works | 4 |
|---|---|
| Citations per year | 0.22 |
| Citation span | 2008 - 2016 (9) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 3 |