The Impact of Medicaid Expansion on Breast and Cervical Cancer Screening Rates

The Impact of Medicaid Expansion on Breast and Cervical Cancer Screening Rates
Author: Madelyn Jane Sather
Publisher:
Total Pages: 40
Release: 2021
Genre:
ISBN:

Download The Impact of Medicaid Expansion on Breast and Cervical Cancer Screening Rates Book in PDF, Epub and Kindle

Screenings are an important public health intervention to prevent breast and cervical cancer. Previous studies have indicated a relationship between Medicaid expansion under the Affordable Care Act (ACA) and breast and cervical cancer screenings, but the results have been mixed and inconclusive. We examined the relationship between Medicaid expansion and breast and cervical cancer screenings among low-income women. In our secondary analyses, we assessed if this association was modified by race/ethnicity or rural residence status. We used data from the Behavioral Risk Factor Surveillance System from 2012-2019, excluding 2017. States that expanded Medicaid before the ACA were excluded. A total of 27 states were considered Medicaid expansion states and 17 were considered non-expansion states. Participants included women with incomes up to 138% of the Federal Poverty Level (FPL) without a previous cancer diagnosis, excluding Medicare-eligible ages. Using a difference-in-difference time series event design, this study compared the odds ratio of breast and cervical cancer screenings for a total of 8 years pre- and post-Medicaid expansion controlling for age, race/ethnicity, education, income, employment, having a regular healthcare provider, rurality, and year and state fixed effects. Dummy variables on years from expansion were created from 7 years before expansion up to 5 years after expansion, including a dummy variable indicating the expansion year. The expansion year dummy variable was coded as 1 if the year of observation was equivalent to the year when the state expanded Medicaid and 0 otherwise. Stratified analyses were used to test if there was an interaction at the multiplicative level by race/ethnicity or rurality. Among 27,290 women aged 40-64, 76.4% of the women residing in expansion states reported having an up-to-date breast cancer screening compared to 70.8% of women residing in non-expansion states. Among 30,808 women aged 18-64, 82.3% of the women residing in expansion states reported having an up-to-date cervical cancer screening compared to 79.9% of women residing in non-expansion states. Medicaid expansion was associated with 2.89-fold higher rate of up-to-date breast cancer screenings 1 year post-expansion (aOR 2.89; 95% CI: 1.34, 6.23). The odds ratios relating Medicaid expansion and up-to-date cervical cancer screenings during the expansion year and 4 years post-expansion were 1.35 (95% CI: 1.14, 1.61) and 1.37 (95% CI: 1.01, 1.85), respectively. The associations were stronger among White non-Hispanic, Black non-Hispanic women, and urban women for both breast and cervical cancer screenings. Medicaid expansion led to higher rates of up-to-date breast and cervical cancer screenings during some years pre- and post-expansion. These associations were modified by race/ethnicity and rurality. Future research should control for baseline rates of up-to-date breast and cervical cancer screening rates. A longitudinal study should be conducted to further control for time-varying confounders. Findings support adoption of Medicaid expansion should be adopted by all states to improve breast and cervical cancer screening rates for low-income women.

Access Standards for Covered Services Within the Pennsylvania Medicaid Program

Access Standards for Covered Services Within the Pennsylvania Medicaid Program
Author: Kelly Abraham
Publisher:
Total Pages: 35
Release: 2010
Genre:
ISBN:

Download Access Standards for Covered Services Within the Pennsylvania Medicaid Program Book in PDF, Epub and Kindle

Background: Breast cancer is the most common cancer in women aside from non melanoma skin cancer (CDC, 2009a) All women are at risk for cervical cancer, but the disease usually occurs in women 30 years and older (CDC, 2010a). Access standards for breast and cervical cancer screenings in the Medicaid program appear to be limited. The study hopes to address standards that define adequate access to breast and cervical cancer screenings for prevention specifically in the Medicaid program. Objectives: To discern if there are prevailing standards for access for breast and cervical cancer screening, to understand accessibility and its various components more thoroughly, to gain a deeper insight into breast and cervical cancer prevention, and to explore and document methods for research on screening standards in order to guide others who may follow up on research or use for other services. Methods: This study consisted of literature searches and reviews specific to access standards, Medicaid, breast cancer, and cervical cancer. Online searches for specific contracts and contacts were targeted to various state departments of health, medical societies for breast and cervical cancer, and national organizations. For information that could not be searched, emails and phone calls were the best ways to obtain the information needed. Results: Given the research, the hypothesis was proven true. Access standards for breast and cervical cancer prevention do not exist for the organizations and departments researched. The importance of creating standards is that it allows for the measurement of access to care. The primary recommendation from this study is that access standards should be developed to measure the effectiveness of breast and cervical cancer screenings and prevention services. The second major recommendation is to develop access standards by researching the actual experience with wait-times for breast and cervical cancer screening. Since the need for access to care standards for breast and cervical cancer screening is addressed, the next question would be how to go about developing standards. Conclusions: The findings suggest there is a gap in information on breast and cervical cancer preventive services. The main recommendation is that access to care standards for breast and cervical cancer preventive services be developed in order to measure access to care in the Medicaid program. This would allow the Medicaid program's breast and cervical cancer preventive services for women to be assessed.

Cervical Cancer in Pennsylvania

Cervical Cancer in Pennsylvania
Author: Pennsylvania. General Assembly. Joint State Government Commission
Publisher:
Total Pages: 110
Release: 2004
Genre: Cervix uteri
ISBN:

Download Cervical Cancer in Pennsylvania Book in PDF, Epub and Kindle

Saving Lives

Saving Lives
Author: Salome Kidele Kapella
Publisher:
Total Pages: 144
Release: 2006
Genre:
ISBN:

Download Saving Lives Book in PDF, Epub and Kindle

Breast and Cervical Cancer Screening Patterns Among Rural Hispanic and American Indian Women in Arizona

Breast and Cervical Cancer Screening Patterns Among Rural Hispanic and American Indian Women in Arizona
Author: Thomas Nuño
Publisher:
Total Pages: 348
Release: 2011
Genre: Breast
ISBN:

Download Breast and Cervical Cancer Screening Patterns Among Rural Hispanic and American Indian Women in Arizona Book in PDF, Epub and Kindle

Breast and cervical cancer disparities among Hispanic and American Indian women are a significant public health problem. Breast cancer is the most common neoplasm among Hispanic women. Cervical cancer has a higher incidence and mortality among Hispanic women compared to non-Hispanic White women. Breast cancer detection often comes late for American Indian women and breast cancer survival for this population is relatively poor. Hispanic and American Indian women who reside in rural areas of Arizona are especially at-risk of non-participation in breast and cervical cancer screening programs. This dissertation utilized data from two sources: a health-education intervention trial designed to increase mammography screening among women living in a rural area along the U.S.-Mexico border of Arizona and survey data from multiple years of the Arizona Behavioral Risk Factor Survey (BRFS) focusing on breast and cervical cancer screening self-reported behaviors. The purpose of the dissertation research was to identify factors associated with cancer screening behaviors among Hispanic and American Indian women that reside in rural Arizona settings. Hispanic women who participated in the 'promotora'-based educational intervention program were more likely to report receiving a mammogram at the followup compared to women who did not participate in the program. Results from both the baseline community survey and the BRFS showed that Hispanic women who received prior recommendations from a clinician to get both mammography and Pap smear were more likely to report they received a mammogram within the past year and a Pap smear within the past three years. Rural Hispanic and American Indian women reported lower rates of ever having had breast and cervical cancer screening compared to their urban counterparts. Breast and cervical cancer screening use in these populations can potentially be increased with at least two strategies. First, clinician recommendation of both mammograms and Pap smears and opportunistic screening during regular clinic visits may increase breast and cervical cancer screening coverage. Secondly, culturally-appropriate interventions that utilize 'promotoras' or lay health advisors could increase screening rates. In conclusion, Hispanic and American Indian women that reside in rural areas of Arizona, whether throughout the State or along the U.S.-Mexico border, are two underserved populations in Arizona with low rates of breast and cervical cancer screening that need to be addressed in order to reduce the burden of cancer in these populations.

Fulfilling the Potential of Cancer Prevention and Early Detection

Fulfilling the Potential of Cancer Prevention and Early Detection
Author: National Research Council
Publisher: National Academies Press
Total Pages: 564
Release: 2003-05-07
Genre: Medical
ISBN: 0309170133

Download Fulfilling the Potential of Cancer Prevention and Early Detection Book in PDF, Epub and Kindle

Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.

Primary Care and Public Health

Primary Care and Public Health
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 212
Release: 2012-07-19
Genre: Medical
ISBN: 0309255201

Download Primary Care and Public Health Book in PDF, Epub and Kindle

Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.

Health, United States, 2016, with Chartbook on Long-Term Trends in Health

Health, United States, 2016, with Chartbook on Long-Term Trends in Health
Author: National Center for Health Statistics
Publisher: Government Printing Office
Total Pages: 494
Release: 2017-08-16
Genre: Health & Fitness
ISBN: 9780160939778

Download Health, United States, 2016, with Chartbook on Long-Term Trends in Health Book in PDF, Epub and Kindle

This annual overview report of national trends in health statistics contains a Chartbook that assesses the nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health-care expenditures. Chapters devoted to population characteristics, prevention, health risk factors, health care resources, personal health care expenditures, health insurance, and trend tables may provide the health/medical statistician, data analyst, biostatistician with additional information to complete experimental studies or provide necessary research for pharmaceutical companies to gain data for modeling and sampling. Undergraduate students engaged in applied mathematics or statistical compilations to graduate students completing biostatistics degree programs to include statistical inference principles, probability, sampling methods and data analysis as well as specialized medical statistics courses relating to epidemiology and other health topics may be interested in this volume. Related products: Your Guide to Choosing a Nursing Home or Other Long-Term Services & Supports available here: https://bookstore.gpo.gov/products/your-guide-choosing-nursing-home-or-other-long-term-services-supports Health Insurance Coverage in the United States, 2014 available here: https://bookstore.gpo.gov/products/health-insurance-coverage-united-states-2014 "Some System of the Nature Here Proposed": Joseph Lovell's Remarks on the Sick Report, Northern Department, U.S. Army, 1817, and the Rise of the Modern US Army Medical Department can be found here: https://bookstore.gpo.gov/products/some-system-nature-here-proposed-joseph-lovells-remarks-sick-report-northern-department-us Guide to Clinical Preventive Services 2014: Recommendations of the U.S. Preventive Services Task Force (ePub) -Free digital eBook download available at the US Government Online Bookstore here: https://bookstore.gpo.gov/products/guide-clinical-preventive-services-2014-recommendations-us-preventive-services-task-force --Also available for FREE digital eBook download from Apple iBookstore, BarnesandNoble.com (Nook Bookstore), Google Play eBookstore, and Overdrive -Please use ISBN: 9780160926426 to search these commercial platforms.

Implementing High-Quality Primary Care

Implementing High-Quality Primary Care
Author: National Academies of Sciences, Engineering, and Medicine
Publisher:
Total Pages: 448
Release: 2021-06-30
Genre:
ISBN: 9780309685108

Download Implementing High-Quality Primary Care Book in PDF, Epub and Kindle

High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.