The Influence of Medicaid and Private Health Insurance on the Early Diagnosis of Breast Cancer

s included age, marital status, tumor histology, other previous cancer occurrence, census tract of residence, and the stage of disease at time of first treatment. For each patient in this study, the type of third-party coverage at the time of first admission was provided by reporting hospitals. 4For a discussion of psychological aspects of delay, see Kutner and Makover (1958, pp. 104108). 5 The seven other cities are Brookline, Dedham, Milton, Needham, Newton, Quincy, and Wellesley. 6Patients residing in institutions or diagnosed at autopsy were ignored. MEDICAL CARE This content downloaded from 207.46.13.144 on Mon, 13 Jun 2016 07:25:51 UTC All use subject to http://about.jstor.org/terms PUBLIC MEDICAL ASSISTANCE AND DIAGNOSIS It was not possible to obtain data for each specific patient on family income and level of education. In the sample of cases, however, more than 125 separate census tracts were represented. These areas differed widely in cost of housing, vacancy rate, and the number of persons per room. This housing information was obtained from the 1970 Census to be used as proxy variables. There is considerable evidence that persons of like economic resources and social background tend to congregate spatially. It has also been noted that expenditure for housing is some indication of permanent income which would seem to be the appropriate income concept when decisions of long-range importance are involved. The special properties of the foregoing variables require detailed discussion of the statistical model that was employed. Statistical Model and Results Our model is that variation in the stage of cancer at time of first diagnosis can be partially attributed to variation in measured and categorized variables. The stage of cancer is a concept that has been developed as a guide to treatment and prognosis of the disease, and for breast cancer there are the following three distinct categories of tumor

Actuarial science · Breast cancer · Business · Cancer · Census · Economic growth · Economics · Environmental health · Family medicine · Health care · Marital status · Medicaid · Population · Proxy (statistics) · Residence · Socioeconomic status · Sociology · Demography · Global Cancer Incidence and Screening · Medicine · Gerontology

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