Utilization of Screening Mammograms in the Medicare Population Before and After the Affordable Care Act Implementation.

Laura M Bozzi, Bruce Stuart, Eberechukwu Onukwugha, Sarah E Tom
Author Information
  1. Laura M Bozzi: University of Maryland School of Pharmacy, Baltimore, USA. ORCID
  2. Bruce Stuart: University of Maryland School of Pharmacy, Baltimore, USA.
  3. Eberechukwu Onukwugha: University of Maryland School of Pharmacy, Baltimore, USA.
  4. Sarah E Tom: Columbia University Mailman School of Public Health, New York, NY, USA.

Abstract

This study examined screening mammograms in women aged 65 to 74 years and 75+ years before and after the Affordable Care Act (ACA) implementation. This repeated cross-sectional study of community-dwelling women age 65+ years without a history of breast cancer or mastectomy utilized the Medicare Current Beneficiary Survey and Medicare fee-for-service claims data from 2001 to 2013. We used covariate-adjusted logistic regression with generalized estimating equations, stratified by age group. The adjusted odds of screening mammograms in women aged 65-74 ( = 742) and 75+ years ( = 681) were lower in 2013 (odds ratio [OR]: 0.75, 95% confidence interval [CI]: [0.67, 0.83]; OR: 0.67, 95% CI: [0.60, 0.75], respectively) than the odds of screening mammograms in 2001. Annual screening mammograms decreased in women aged 65 to 74 years and 75+ years, despite increased access from the ACA implementation. Future research as to why women are no longer receiving screening mammograms, such as changes in physician specialty guidelines, is warranted.

Keywords

References

  1. J Womens Health (Larchmt). 2013 Jan;22(1):19-25 [PMID: 23145890]
  2. Ann Intern Med. 2009 Nov 17;151(10):716-26, W-236 [PMID: 19920272]
  3. J Rheumatol. 2013 Feb;40(2):137-43 [PMID: 23322458]
  4. Womens Health Issues. 2014 May-Jun;24(3):e313-9 [PMID: 24794545]
  5. JAMA. 1999 May 26;281(20):1900-5 [PMID: 10349893]
  6. J Gen Intern Med. 2014 Jan;29(1):82-9 [PMID: 23943421]
  7. Ann Intern Med. 2002 Sep 3;137(5 Part 1):344-6 [PMID: 12204019]
  8. JAMA. 2014 Apr 2;311(13):1327-35 [PMID: 24691608]
  9. PLoS One. 2015 Jun 29;10(6):e0131903 [PMID: 26121485]
  10. Am J Prev Med. 2015 Sep;49(3):419-22 [PMID: 25841980]
  11. Can Fam Physician. 2005 Dec;51:1658-9 [PMID: 16926946]
  12. Am J Obstet Gynecol. 2011 Sep;205(3):201.e1-5 [PMID: 21689807]
  13. JAMA. 2012 Feb 8;307(6):590-7 [PMID: 22318280]
  14. Cancer. 2011 Jul 15;117(14):3101-11 [PMID: 21246531]
  15. AJR Am J Roentgenol. 2016 Nov;207(5):959-964 [PMID: 27504599]
  16. Am J Prev Med. 2016 May;50(5):e123-e131 [PMID: 26699245]
  17. J Natl Cancer Inst. 2015 Dec 06;108(5): [PMID: 26640244]
  18. Womens Health Issues. 2015 May-Jun;25(3):239-45 [PMID: 25965155]
  19. Eur Radiol. 2016 Nov;26(11):3899-3907 [PMID: 26943342]
  20. Am J Manag Care. 2015 Jul;21(7):511-7 [PMID: 26247741]
  21. J Am Board Fam Pract. 2001 Sep-Oct;14(5):352-61 [PMID: 11572540]

Grants

  1. T32 AG000262/NIA NIH HHS

MeSH Term

Advisory Committees
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Guidelines as Topic
Humans
Mammography
Mass Screening
Medicare
Patient Acceptance of Health Care
Patient Protection and Affordable Care Act
United States

Word Cloud

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