Breast cancer outcomes among older women: HMO, fee-for-service, and delivery system comparisons

Journal of General Internal Medicine
A Lee-FeldsteinG Katterhagen

Abstract

To analyze the relationship of health insurance status and delivery systems to breast cancer outcomes--stage at diagnosis, treatment selected, survival--focusing on comparisons among women aged 65 or more having Medicare alone, Medicare/Medicaid, or Medicare with group model HMO, non-group model HMO, or private fee-for-service (FFS) supplement. Retrospectively defined cohort from Sacramento, Calif, regional cancer registry. Thirteen-county region in northern California with mature managed care market. Female invasive breast cancer patients aged 65 or more (N = 1,146), diagnosed 1987-1993. Health insurance was determined from hospital records. Outcomes were analyzed with multivariate regression models, controlling for age, ethnicity, time, and SES measures. Stage I diagnosis was more likely among group model HMO patients than among private FFS insured (odds ratio [OR], 1.42; 95% confidence interval [CI], 0.84 to 2.40). Stage I tumors were significantly less likely for Medicaid patients (OR, 0.50; 95% CI, 0.31 to 0.82). Use of breast-conserving surgery plus radiation (BCS+) varied significantly by hospital type (including HMO-owned and various-sized community hospitals) and time. Survival of patients with private FFS, group-, and...Continue Reading

References

Oct 1, 1992·American Journal of Public Health·B L Wells, J W Horm
Apr 23, 1992·The New England Journal of Medicine·D C FarrowJ M Samet
Apr 23, 1992·The New England Journal of Medicine·A B NattingerJ S Goodwin
May 1, 1990·Preventive Medicine·C LermanP F Engstrom
Oct 1, 1995·American Journal of Public Health·M E JohantgenJ J Clinton
Apr 27, 1995·The New England Journal of Medicine·J Blustein
Oct 1, 1994·American Journal of Public Health·G F RileyM L Brown
May 1, 1996·Medical Care·A B NattingerJ S Goodwin
Jun 5, 1996·Journal of the National Cancer Institute·R Ballard-BarbashL G Kessler
May 1, 1997·Health Affairs·J Gabel
Jan 1, 1997·Annual Review of Public Health·N KriegerN E Moss
Dec 9, 1997·Journal of the National Cancer Institute·A L PotoskyR Ballard-Barbash
Mar 3, 1999·JAMA : the Journal of the American Medical Association·G F RileyR Ballard-Barbash

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Citations

Nov 17, 2004·Annals of Surgical Oncology·Anthony LucciAli Azzizadeh
Oct 14, 2008·Qualitative Health Research·Jennifer Wenzel, Richard H Steeves
Jul 3, 2020·Journal of Policy Analysis and Management : [the Journal of the Association for Public Policy Analysis and Management]·Rebecca M MyersonDarius N Lakdawalla
May 1, 2021·Journal of Women's Health·Lee R MobleySusan A Sabatino

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