Health insurance and mammography: would a Medicare buy-in take us to universal screening?

Journal Article (Journal Article)

OBJECTIVE:To determine whether health insurance expansions via a Medicare buy-in might plausibly increase mammography screening rates among women aged 50-64. DATA SOURCES:Two waves of the Health and Retirement Study (HRS) (1994, 1996). STUDY DESIGN:A longitudinal study with most explanatory variables measured at the second wave of HRS (1994); receipt of mammography, number of physician visits, and breast self exam (BSE) were measured at the third wave (1996). DATA EXTRACTION:Our sample included women aged 50-62 in 1994 who answered the second and third HRS interview (n = 4,583). PRINCIPAL FINDINGS:From 1994 to 1996, 72.7 percent of women received a mammogram. Being insured increased mammography in both unadjusted and adjusted analyses. A simulation of universal insurance coverage in this age group increased mammography rates only to 75-79 percent from the observed 72.7 percent. When we accounted for potential endogeneity of physician visits and BSE to mammography, physician visits remained a strong predictor of mammography but BSE did not. CONCLUSION:Even in the presence of universal coverage and very optimistic scenarios regarding the effect of insurance on mammography for newly insured women, mammography rates would only increase a small amount and gaps in screening would remain. Thus, a Medicare buy-in could be expected to have a small impact on mammography screening rates.

Full Text

Duke Authors

Cited Authors

  • Taylor, DH; Van Scoyoc, L; Hawley, ST

Published Date

  • December 2002

Published In

Volume / Issue

  • 37 / 6

Start / End Page

  • 1469 - 1486

PubMed ID

  • 12546282

Pubmed Central ID

  • PMC1464038

Electronic International Standard Serial Number (EISSN)

  • 1475-6773

International Standard Serial Number (ISSN)

  • 0017-9124

Digital Object Identifier (DOI)

  • 10.1111/1475-6773.01312


  • eng