Time to Follow-up After Colorectal Cancer Screening by Health Insurance Type.
California
Colonoscopy
/ statistics & numerical data
Colorectal Neoplasms
/ diagnosis
Early Detection of Cancer
/ statistics & numerical data
Female
Humans
Insurance Coverage
/ statistics & numerical data
Insurance, Health
/ classification
Kaplan-Meier Estimate
Male
Medicaid
/ statistics & numerical data
Middle Aged
Occult Blood
Proportional Hazards Models
Retrospective Studies
Safety-net Providers
/ statistics & numerical data
Texas
Time-to-Treatment
United States
Journal
American journal of preventive medicine
ISSN: 1873-2607
Titre abrégé: Am J Prev Med
Pays: Netherlands
ID NLM: 8704773
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
24
02
2018
revised:
03
01
2019
accepted:
04
01
2019
entrez:
21
4
2019
pubmed:
21
4
2019
medline:
3
6
2020
Statut:
ppublish
Résumé
The purpose of this study was to test the hypothesis that patients with Medicaid insurance or Medicaid-like coverage would have longer times to follow-up and be less likely to complete colonoscopy compared with patients with commercial insurance within the same healthcare systems. A total of 35,009 patients aged 50-64years with a positive fecal immunochemical test were evaluated in Northern and Southern California Kaiser Permanente systems and in a North Texas safety-net system between 2011 and 2012. Kaplan-Meier estimation was used between 2016 and 2017 to calculate the probability of having follow-up colonoscopy by coverage type. Among Kaiser Permanente patients, Cox regression was used to estimate hazard ratios and 95% CIs for the association between coverage type and receipt of follow-up, adjusting for sociodemographics and health status. Even within the same integrated system with organized follow-up, patients with Medicaid were 24% less likely to complete follow-up as those with commercial insurance. Percentage receiving colonoscopy within 3 months after a positive fecal immunochemical test was 74.6% for commercial insurance, 63.10% for Medicaid only, and 37.5% for patients served by the integrated safety-net system. This study found that patients with Medicaid were less likely than those with commercial insurance to complete follow-up colonoscopy after a positive fecal immunochemical test and had longer average times to follow-up. With the future of coverage mechanisms uncertain, it is important and timely to assess influences of health insurance coverage on likelihood of follow-up colonoscopy and identify potential disparities in screening completion.
Identifiants
pubmed: 31003603
pii: S0749-3797(19)30038-8
doi: 10.1016/j.amepre.2019.01.005
pmc: PMC6820676
mid: NIHMS1055874
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e143-e152Subventions
Organisme : NCI NIH HHS
ID : UM1 CA222035
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA163307
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA163261
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA163262
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA163308
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA163304
Pays : United States
Informations de copyright
Copyright © 2019. Published by Elsevier Inc.
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