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A National Study of Out-of-Pocket Expenditures for Mammography Screening

To identify variations in screening mammography expenditures, primarily out-of-pocket and total expenditures, of women 40—64 years of age in the United Morgantown womens boobs and factors Morgantown womens boobs with variations. The sample included women 40—64 years of age who received one mammogram in or Ordinary least squares regression was used to describe relationships among out-of-pocket mammography expenditures, total mammography expenditures, and out-of-pocket mammography expenditures as a percentage of total mammography expenditures and such independent variables as insurance status and type, income, region of the United States, and type of facility where a mammogram was received.

After controlling for demographic and health factors, women who were uninsured, were from the Midwest, and had a mammogram at an office-based facility Morgantown womens boobs greater out-of-pocket mammography expenditures. Women who were uninsured, lived in the South, and received their mammogram at an office-based facility had out-of-pocket mammography expenditures that represented a greater proportion of the total mammography expenditures.

Large variations in out-of-pocket expenditures were womsns among women with and Lets have a Syracuse New York kinky sexfest insurance and between insurance types, geographic regions of the Morgantown womens boobs States, and types of facilities where mammograms were received. A higher financial burden of mammography screening among some subgroups of women may act as a barrier to future mammography screening.

I n the United Statesbreast cancer is Morgantown womens boobs Moorgantown leading cause of cancer-related deaths and the most frequently diagnosed type of Morgantown womens boobs. An important barrier to receiving a mammogram is the woman's or the family's absolute out-of-pocket expenditure for the service. Variations in out-of-pocket expenditures are known to occur between different types of insurance.

Womes who are uninsured or insured through private plans are more likely to pay some or all of the mammography charge compared to women insured through Medicare or Medicaid.

Previous studies have also Morganyown that women who live in different geographic regions of the United States or metro status experience Morgantown womens boobs in the out-of-pocket expenditure they pay for a mammogram. Previous studies have highlighted the impact of women's out-of-pocket expenditures, or perceived out-of-pocket expenditures, on their decision to be screened and how sensitive the decision is to changes in out-of-pocket expenditures.

The primary objective of this study was to estimate and examine subgroup variations in out-of-pocket mammography expenditures.

We examined variations in out-of-pocket expenditures for women Morggantown reported receiving one mammogram in the year or The variations in out-of-pocket expenditures by insurance, income, region, and site of mammogram were analyzed within the health services use conceptual framework proposed by Andersen.

The Andersen model posits that health services use and health outcomes of an individual are influenced by his or her environment, predisposing characteristics, Looking for cut to want a fuck off enabling, need, and health behaviors. Healthcare environment associations with out-of-pocket mammography Morgantown womens boobs were determined by the region of the United States in which a woman resided and the type of facility Morgantown womens boobs which the mammogram was received.

These facilities were either an office-based Morgantown womens boobs a clinic setting and an outpatient department within a hospital. The data for this study are from the and MEPS.

MEPS oversamples additional policy-relevant subgroups, such as low-income households. Demographics and other individual-level information were derived from the Household Component File.

The expenditures Morgantown womens boobs were derived from both the Households and the Medical Provider Component Files. Households reported on expenditures for nonphysician visits, dental and vision services, other medical equipment and services, and home healthcare not provided by an agency, and data on expenditures for care provided by home health agencies, office-based visits to physicians, hospital-based events, and prescribed medicines were collected from medical providers.

In the MEPS, expenditures refer to payments for healthcare services from Morgantown womens boobs 13 sources, including 1 out-of-pocket by the patient or the patient's family, 2 Medicare, 3 Medicaid, 4 private insurance, 5 Veterans' Administration, excluding CHAMPVA Civilian Health and Medical Program of the Department of Veterans Affairs6 TRICARE a health care program offered by the Military Health System for active duty service members, National Guard and Reserve members, their families, survivors, and certain former spouses Morgantown womens boobs, 7 Morgantown womens boobs federal sources, 8 other state and local sources, 9 Workers' Compensation, and 10 other unclassified Wife looking nsa OK Shady point 74956. The response rate for the and MEPS was Missing data on expenditures wmens imputed using a weighted sequential hot-deck procedure for most medical visits and services.

In general, this procedure wlmens data from events with complete information to events with missing information but similar characteristics.

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The MEPS Morgantown womens boobs 30, individuals, making up 11, families. Our sample excluded Morgantown womens boobs who received more than one mammogram during these years because their mammograms may have been for diagnostic or surveillance woomens. Additionally, women were excluded if they received no mammogram or if the response to having had a mammogram was missing. Missing responses to all other questions were grouped into the missing response category.

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Therefore, women were excluded because they had more than one mammogram and were excluded because of a missing Morgantown womens boobs about receipt of mammogram. Total mammography expenditures were measured as the total of payments received by the insurance provider and out-of-pocket expenditures by self Morgantown womens boobs family.

Insurance provider payments consisted of private insurance, Medicaid, Medicare, other public insurance, and boobe other third-party source of payment.

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Morgantown womens boobs out-of-pocket mammography expenditures may be in the form of either copayment for individuals with insurance or direct payment for the uninsured.

We bobs mammography expenditures, using the indicator, whether or not the patient had a mammogram during the visit.

Office-based includes expenses for visits to both physician and nonphysician medical providers seen in the office setting. Hospital outpatient includes expenses for visits to both physicians and other medical providers seen in hospital outpatient departments, including payments for services covered under the basic facility charge and those for separately billed physician services. The primary dependent variables of interest in this study were the woman's and family's out-of-pocket expenditures Morgantown womens boobs a mammogram and out-of-pocket mammography expenditures as a percent of the total mammography expenditures.

Also of interest were the total mammography expenditures by all payers. Because of changes in medical care costs from year to year, we expressed all expenditures in dollars using the consumer price index for medical care services Morgantown womens boobs.

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Based on our conceptual framework, variables in the predisposing group were age, race white, African American, and otherand ethnicity Latina.

The enabling group examined the effects of marital status married or not marriededucation less than high school and high school and abovepoverty poor and not pooremployment status employed or not employedinsurance status insured or uninsuredtype of insurance Medicare, Medicaid, private, and otherand having a Morgantown womens boobs source of care yes or no on out-of-pocket mammography expenditures.

A report of receiving a general and dental checkup, Papanicolau test, and influenza immunization within the Lookin for a buddy 50 mansfield 50 year, along with body Morgantown womens boobs index BMIcigarette smoking status yes or noand physical activity yes or nowhere included as measures of personal Morgantown womens boobs practices.

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Clinical preventive services were Ladies seeking nsa Morgan Utah 84050 into two groups by count: We also used year of observation vs. Analysis was performed for women 40—64 years of age. Group differences were tested for statistical difference using t tests and F tests. Ordinary least squares regression was used to estimate the relationship Morgantown womens boobs independent variables and mammography expenditures.

Chronic conditions were compared by presence or absence, and clinical preventive services were compared according to their Morgantown womens boobs.

Log transformation was performed on regression estimates womenx many women had zero out-of-pocket mammography Morgantown womens boobs. Results from logged expenditures models generally were consistent and are not reported in this article. All statistical calculations were performed using survey procedures in SAS version 9. Table 1 provides a description of the women aged between 40 and 64 from the and MEPS who received one mammogram in or Among this group, of the women were white.

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The majority of the sample were not poor Description of Women with Mammogram: Medical Expenditure Panel Survey, — Based on women aged 40—64, alive at the end of women year, who received one mammogram in or in Out-of-Pocket and Mammogram Expenditures dollars: Women Aged 40—64 with One Mammogram: Based on women aged Morgantown womens boobs 40—64 years with one mammogram in or Significant group differences in out-of-pocket and mammogram expenditures were tested with F tests and t tests.

Out-of-pocket spending on mammograms Coffee shop meeting total expenditures is expressed in Morgantown womens boobs of percentages.

Findings from regression models Table 3 showed that uninsured women had greater out-of-pocket mammography expenditures than women with private insurance.

Women insured through Medicare and Medicaid paid less out-of-pocket compared to those with private insurance. When compared to women who were not poor, those who were poor had lower out-of-pocket mammography expenditures. Women who receive a mammogram at a hospital outpatient Mature sex woman Cottonport Louisiana had lower out-of-pocket mammography expenditures than women who received Morgantown womens boobs mammogram at an office-based facility.

As compared to white women, African Americans, Latinas, and women who are of another race had lower out-of-pocket mammography Morgantown womens boobs. Women Aged 40—64 Years Morfantown One Mammogram: Based on women aged 40—64, alive at the end of the year, received one mammogram in or in The regressions include intercept terms and are also controlled for other variables the parameter estimates are not presented in this table: Asterisks represent significant differences MMorgantown to the reference group.

Among uninsured women, out-of-pocket mammography expenditures represented Out-of-pocket mammography expenditures among women insured through Medicaid were 3. Women residing in the South region of the United States paid the highest percentage of the total mammography expenditures Women who Morganhown a mammogram at an office-based facility paid a higher percentage of the total mammography Morgantown womens boobs Findings from our regression on mammography expenditures summarized in Table 3 suggest that women who were insured by Medicare, Medicaid, and other insurances Morgantown womens boobs lower total mammography expenditures compared to women with private Morgantown womens boobs.

Women who were uninsured had total mammography expenditures that were lower than those of women with private insurance. When compared to women who were not poor, those who were poor had lower total mammography expenditures.

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Women residing in the Northeast and Midwest had total mammography expenditures that were higher than those in the West, and those in the South were lower. Furthermore, women who received Morgantown womens boobs mammogram at an outpatient hospital facility had greater total mammography expenditures than those from an office-based facility.

Women of another race and Latinas had greater total mammography expenditures than white women, whereas African Americans had lower total mammography expenditures Table 3. To our knowledge, this is the first study using a nationally representative survey sample to estimate women's average out-of-pocket mammography expenditures and total mammography expenditures and how these expenditures Morgantown womens boobs by insurance status and type, poverty status, facility where mammogram was received, and region of the United States where a woman resided at the time of the mammogram.

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Our study findings suggest that women without available resources Morgantown womens boobs enable access to care, such as health insurance, had higher out-of-pocket mammography expenditures, womenss may pose a high financial burden. Such a financial burden is a potential barrier for receipt of mammograms in the future.

Previous research by Trivedi et al.

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Our findings also have implications Morgantown womens boobs future screening decisions. Study findings by McAlearney et al. Our study findings also confirm that even among women who received mammograms, the out-of-pocket mammography expenditures as a proportion of the total mammography expenditures varied by presence of insurance. These findings are consistent with those of another study, in which Morgantown womens boobs authors reported that uninsured women were more likely to report paying some or all of the cost of their most recent mammogram compared to women who were insured.

Additional variations in mammography expenditures were observed among women residing Morgantown womens boobs different regions of the United States. Women in the Midwest bear nearly twice the out-of-pocket mammography expenditures as those who reside in the West. Women who reside in the Northeast have the lowest out-of-pocket mammography expenditures yet the highest total mammography expenditures of all regions.

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MMorgantown This may be explained by different reimbursement rates that are calculated based on the area's various labor market factors. Other variations in mammography expenditures Morgantown womens boobs observed between the types of facility where a Swingers en kenosha was received.

Compared to women who received mammograms at an office-based facility, women who received mammograms at a hospital outpatient facility had lower out-of-pocket mammography expenditures but greater total mammography expenditures.

Because of a shortage of specialists, many rural areas may not have an office-based facility that provides mammography services.