Does retirement affect secondary preventive care use? Evidence from breast cancer screening.
Ontology highlight
ABSTRACT:
SUBMITTER: Eibich P
PROVIDER: S-EPMC8683749 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:Purpose To retrospectively assess whether there is an association between screening mammography and the use of a variety of preventive services in women who are enrolled in Medicare. Materials and Methods U.S. Medicare claims from 2010 to 2014 Research Identifiable Files were reviewed to retrospectively identify a group of women who underwent screening mammography and a control group without screening mammography in 2012. The screened group was divided into positive versus negative results at screening, and the positive subgroup was divided into false-positive and true-positive findings. Multivariate logistic regression models and inverse probability of treatment weighting were used to examine the relationship between screening status and the probabilities of undergoing Papanicolaou test, bone mass measurement, or influenza vaccination in the following 2 years. Results The cohort consisted of 555 705 patients, of whom 185 625 (33.4%) underwent mammography. After adjusting for patient demographics, comorbidities, geographic covariates, and baseline preventive care, women who underwent index screening mammography (with either positive or negative results) were more likely than unscreened women to later undergo Papanicolaou test (odds ratio [OR], 1.49; 95% confidence interval: 1.40, 1.58), bone mass measurement (OR, 1.70; 95% confidence interval: 1.63, 1.78), and influenza vaccine (OR, 1.45; 95% confidence interval: 1.37, 1.53). In women who had not undergone these preventive measures in the 2 years before screening mammography, use of these three services after false-positive findings at screening was no different than after true-negative findings at screening. Conclusion In beneficiaries of U.S. Medicare, use of screening mammography was associated with higher likelihood of adherence to other preventive guidelines, without a negative association between false-positive results and cervical cancer screening.
| S-EPMC6122660 | biostudies-literature
Project description:To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care.Observational studies at primary care practice level.Studies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition.The primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions.48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed.The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions.
| S-EPMC4039790 | biostudies-other
Project description:The Five-Factor model of personality has been associated with a wide range of health behaviors and health outcomes. However, few studies have examined whether personality traits are related to cancer screening in older adults. The present study investigated the cross-sectional associations between personality traits and the probability of obtaining a recent preventive screening for breast, cervical, prostate, and colorectal cancer. Participants from the Health and Retirement Study (N = 14,394, Mage = 68.14 years, range = 50-102 years, 58.6% female) completed a personality inventory and reported on cancer screenings in the 2010-2012 assessment. Logistic regression models were used to analyze the data, including age, race, ethnicity, gender, education, income, and wealth as covariates. Higher conscientiousness was associated with a higher likelihood of obtaining breast, cervical, and prostate screening. Higher extraversion was related to higher odds of breast, cervical, and colorectal screening. Higher neuroticism was linked to higher odds of colorectal screening, and conscientiousness moderated the link between neuroticism and cervical screening. These associations were significant in models that accounted for demographic and socioeconomic factors. The effect sizes were in the range of a 10-20% higher likelihood of cancer screening for 1 SD difference in personality. The present findings suggest that conscientiousness and extraversion were related to preventive cancer screenings, whereas neuroticism, openness and agreeableness were largely unrelated to the likelihood of such screenings. If these results are further replicated, health policy makers may consider personality traits when planning and implementing screening recommendations to improve preventive medicine.
| S-EPMC6810562 | biostudies-literature
Project description:Objective To assess the effect of unintended births on preventive and curative care of children and their nutritional status. Design The study uses a cross-sectional prospective design. Setting Indian Human Development Survey (IHDS) data of two rounds were used in this study. Women data file was used to draw a representative sample of 3905 children who belong to under 5 years of age group. Statistical analyses We categorised birth as an unintended birth if the mother did not want to have an additional child at IHDS-I but gave birth during the intersurvey. Furthermore, all births exceeding to the desired number of children reported by mothers in the IHDS-II were also included in unintended births. Multivariate logistic regression models were applied to analyse the effect of unintended births on child immunisation and exclusive breast feeding, while multivariate linear regression models were used to assess the effect of childbearing intention on child nutritional status. Results The study shows that by controlling other factors, children from unintended births were less likely to be exclusively breast fed (OR 0.885, 95% CI 0.792 to 0.990, p<0.05) and receive full immunisation (OR 0.830, 95% CI 0.739 to 0.931, p<0.001). Moreover, poor nutrition was more prevalent among children from unintended births as they were more likely to be stunted and underweight. Conclusions The study confirmed the adverse effects of unintended pregnancy on children’s preventive and curative care. The findings of the study underscore the importance of formulating policies on more affordable, accessible and available means of family planning to reduce the unintended births.
| S-EPMC8039270 | biostudies-literature
Project description:BackgroundThis systematic review is an update of evidence since the 2002 U.S. Preventive Services Task Force recommendation on breast cancer screening.PurposeTo determine the effectiveness of mammography screening in decreasing breast cancer mortality among average-risk women aged 40 to 49 years and 70 years or older, the effectiveness of clinical breast examination and breast self-examination, and the harms of screening.Data sourcesCochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the fourth quarter of 2008), MEDLINE (January 2001 to December 2008), reference lists, and Web of Science searches for published studies and Breast Cancer Surveillance Consortium for screening mammography data.Study selectionRandomized, controlled trials with breast cancer mortality outcomes for screening effectiveness, and studies of various designs and multiple data sources for harms.Data extractionRelevant data were abstracted, and study quality was rated by using established criteria.Data synthesisMammography screening reduces breast cancer mortality by 15% for women aged 39 to 49 years (relative risk, 0.85 [95% credible interval, 0.75 to 0.96]; 8 trials). Data are lacking for women aged 70 years or older. Radiation exposure from mammography is low. Patient adverse experiences are common and transient and do not affect screening practices. Estimates of overdiagnosis vary from 1% to 10%. Younger women have more false-positive mammography results and additional imaging but fewer biopsies than older women. Trials of clinical breast examination are ongoing; trials for breast self-examination showed no reductions in mortality but increases in benign biopsy results.LimitationStudies of older women, digital mammography, and magnetic resonance imaging are lacking.ConclusionMammography screening reduces breast cancer mortality for women aged 39 to 69 years; data are insufficient for older women. False-positive mammography results and additional imaging are common. No benefit has been shown for clinical breast examination or breast self-examination.
| S-EPMC2972726 | biostudies-literature
Project description:IntroductionAlthough there is general agreement among various guidelines on benefits of routine screening mammography, the age of screening initiation and the optimal frequency of the test remain controversial. In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended against routine breast cancer screening in women aged younger than 50 years. In this study, screening mammography guideline adherence among U.S. women is explored by examining patterns in rates of mammography age of initiation and utilization in years prior to and following the 2009 USPSTF guideline implementation.MethodsU.S. population-based data from the 2007, 2008, 2010, and 2012 Behavioral Risk Factor Surveillance System surveys were used to measure the overall proportion and rate of change in the proportion of women who underwent screening mammography within the last year, by age and survey year. Data were accessed and analyzed in July 2014.ResultsRates of mammography screening were lower in 2010 and 2012 compared with 2007 and 2008 (p<0.0001). The rate of screening initiation at age 40 years increased over time and was the highest in the years following USPSTF guideline changes (p=0.012).ConclusionsThese data support no perceptible change in U.S. women's patterns of screening mammography age at initiation within 3 years of the USPSTF guideline revision. Whether this finding reflects a delayed effect of guideline revision in population trends or rather health provider practice and patient preference for more frequent screening is unclear and requires further investigation.
| S-EPMC4546897 | biostudies-literature
Project description:We compared the effectiveness of two outreach strategies on timely mammography adherence: a mammogram-specific reminder letter (sent just before a woman was due) to a birthday letter (addresses multiple preventive services and not timed around due dates). We evaluated screening mammography adherence following 79,848 mammogram-specific and 151,626 birthday letters mailed between 2002 and 2012 to women aged 40-74years enrolled in Kaiser Permanente Washington. Screening mammogram adherence was specifically tied to due date and was evaluated separately by age group and up-to-date or overdue status at the time of mailing. We used generalized estimating equations to account for correlation between repeated observations, to model the odds of screening mammography adherence by letter type. Among women up-to-date, adherence following birthday letters was 22-76% lower compared to the mammogram-specific reminders, with the greatest decreases in adherence in women aged 70-74. Birthday letters were more effective at activating screening uptake among some subgroups of overdue women aged 50-69 and most overdue women aged 70-74, but universally low adherence rates were observed in overdue women. Increasing number of recommended services for women aged 50-74 who were up-to-date resulted in 12-17% lower mammography adherence, but had no effect in women aged 40-49 or in overdue women. Birthday letters are less effective than mammogram-specific reminder letters at prompting women to undergo timely breast cancer screening, particularly among women up-to-date with screening. Birthday letters may be effective at increasing overall preventive care; however, supplemental outreach may be needed around the due date to increase timely preventive services receipt.
| S-EPMC5638650 | biostudies-literature
Project description:OBJECTIVE:To review evidence-based (EB) recommendations on survivorship care for primary care providers (PCPs) in EB breast cancer guidelines. DESIGN AND SETTING:Guidelines were collected via experts and via literature database, guideline database and cancer agency websites searches. METHOD:EB guidelines in any language published between 2012 and 2017 were collected. EB recommendations on survivorship care relevant for PCPs were extracted and grouped into three categories (recurrence detection, long-term effects and recurrence prevention). The content of the recommendations was analysed and summarised in the number and type of clinical topics addressed. The Appraisal of Guidelines for Research and Evaluation II instrument was used to evaluate the methodological quality of the guidelines. RESULTS:Six guidelines, of which two were of acceptable methodological quality, were included. One was specifically made for general practitioners. Fifteen clinical topics were identified. Guidelines differed in the clinical topics addressed and for some identical topics in the content of the recommendations. Many recommendations were based on low-quality evidence. Recurrence detection received most attention, physical examination and mammography were often highlighted. Potential complications largely varied in number and type. Intimacy concerns, vaginal dryness, dyspareunia, fatigue, menopausal symptoms, peripheral neuropathy and lymphedema were reported in more than one guideline. Recurrence prevention was mentioned in four guidelines; all recommended physical activity. CONCLUSION:The number of EB recommendations in guidelines is limited. Moreover, recommendations differ between guidelines and most are based on low-quality evidence. More high-quality research is needed to develop and adapt guidelines to support PCPs in providing optimal breast cancer survivorship care.
| S-EPMC5728293 | biostudies-literature
Project description:ImportanceThe Human Immunodeficiency Virus (HIV) epidemic has evolved, with an increasing non-communicable disease (NCD) burden emerging and need for long-term management, yet there are limited data to help delineate the optimal care model to screen for NCDs for this patient population.ObjectiveThe primary aim was to compare rates of NCD preventive screening in persons living with HIV/AIDS (PLWHA) by type of HIV care model, focusing on metabolic/cardiovascular disease (CVD) and cancer screening. We hypothesized that primary care models that included generalists would have higher preventive screening rates.DesignProspective observational cohort study.SettingPartners HealthCare System (PHS) encompassing Brigham & Women's Hospital, Massachusetts General Hospital, and affiliated community health centers.ParticipantsPLWHA age >18 engaged in active primary care at PHS.ExposureHIV care model categorized as infectious disease (ID) providers only, generalist providers only, or ID plus generalist providers.Main outcome(s) and measures(s)Odds of screening for metabolic/CVD outcomes including hypertension (HTN), obesity, hyperlipidemia (HL), and diabetes (DM) and cancer including colorectal cancer (CRC), cervical cancer, and breast cancer.ResultsIn a cohort of 1565 PLWHA, distribution by HIV care model was 875 ID (56%), 90 generalists (6%), and 600 ID plus generalists (38%). Patients in the generalist group had lower odds of viral suppression but similar CD4 counts and ART exposure as compared with ID and ID plus generalist groups. In analyses adjusting for sociodemographic and clinical covariates and clustering within provider, there were no significant differences in metabolic/CVD or cancer screening rates among the three HIV care models.ConclusionsThere were no notable differences in metabolic/CVD or cancer screening rates by HIV care model after adjusting for sociodemographic and clinical factors. These findings suggest that HIV patients receive similar preventive health care for NCDs independent of HIV care model.
| S-EPMC5218477 | biostudies-literature
Project description: Not available
| S-EPMC8131452 | biostudies-literature