Managed care enrollment and chronically disabled women with breast cancer

Elizabeth B Habermann, Beth A. Virnig, Sara B. Durham, Nancy N. Baxter

Research output: Contribution to journalArticle

Abstract

Objective: To assess whether managed care enrollment or healthcare utilization level among women enrolled in Medicare because of disability affects stage at diagnosis and treatment of breast cancer. Study Design: Retrospective study using the Surveillance, Epidemiology, and End Results-Medicare database. We compared breast cancer stage at diagnosis and treatment among women with disabilities enrolled in Medicare managed care versus fee-for-service (FFS) Medicare. Women enrolled in FFS Medicare were classified into levels of healthcare utilization during the 6 to 18 months before breast cancer diagnosis. Methods: Controlling for confounders, we used regression models to determine the effects of managed care enrollment and healthcare utilization level on earlier stage at diagnosis and treatment of breast cancer. Results: Disabled patients enrolled in FFS Medicare without contact with the healthcare system and those with fewer than 12 physician visits during the 6 to 18 months before breast cancer diagnosis were more likely than disabled patients enrolled in Medicare managed care to be diagnosed as having breast cancer at a late stage. There was no difference between women enrolled in Medicare managed care versus women enrolled in FFS Medicare having at least 12 physician visits during the 12-month period. Breast cancer treatment for women with disabilities did not vary across managed care enrollment or healthcare utilization level. Conclusion: Managed care enrollment or increased contact with healthcare providers could result in earlier stage at breast cancer diagnosis.

Original languageEnglish (US)
Pages (from-to)514-520
Number of pages7
JournalAmerican Journal of Managed Care
Volume14
Issue number8
StatePublished - Aug 2008
Externally publishedYes

Fingerprint

Managed Care Programs
Medicare
managed care
cancer
Breast Neoplasms
Fee-for-Service Plans
fee
utilization
Delivery of Health Care
disability
physician
contact
Physicians
epidemiology
Therapeutics
surveillance
Health Personnel
Epidemiology
Retrospective Studies
regression

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Managed care enrollment and chronically disabled women with breast cancer. / Habermann, Elizabeth B; Virnig, Beth A.; Durham, Sara B.; Baxter, Nancy N.

In: American Journal of Managed Care, Vol. 14, No. 8, 08.2008, p. 514-520.

Research output: Contribution to journalArticle

Habermann, Elizabeth B ; Virnig, Beth A. ; Durham, Sara B. ; Baxter, Nancy N. / Managed care enrollment and chronically disabled women with breast cancer. In: American Journal of Managed Care. 2008 ; Vol. 14, No. 8. pp. 514-520.
@article{e0e697ee0331469a885e56d35d32dd65,
title = "Managed care enrollment and chronically disabled women with breast cancer",
abstract = "Objective: To assess whether managed care enrollment or healthcare utilization level among women enrolled in Medicare because of disability affects stage at diagnosis and treatment of breast cancer. Study Design: Retrospective study using the Surveillance, Epidemiology, and End Results-Medicare database. We compared breast cancer stage at diagnosis and treatment among women with disabilities enrolled in Medicare managed care versus fee-for-service (FFS) Medicare. Women enrolled in FFS Medicare were classified into levels of healthcare utilization during the 6 to 18 months before breast cancer diagnosis. Methods: Controlling for confounders, we used regression models to determine the effects of managed care enrollment and healthcare utilization level on earlier stage at diagnosis and treatment of breast cancer. Results: Disabled patients enrolled in FFS Medicare without contact with the healthcare system and those with fewer than 12 physician visits during the 6 to 18 months before breast cancer diagnosis were more likely than disabled patients enrolled in Medicare managed care to be diagnosed as having breast cancer at a late stage. There was no difference between women enrolled in Medicare managed care versus women enrolled in FFS Medicare having at least 12 physician visits during the 12-month period. Breast cancer treatment for women with disabilities did not vary across managed care enrollment or healthcare utilization level. Conclusion: Managed care enrollment or increased contact with healthcare providers could result in earlier stage at breast cancer diagnosis.",
author = "Habermann, {Elizabeth B} and Virnig, {Beth A.} and Durham, {Sara B.} and Baxter, {Nancy N.}",
year = "2008",
month = "8",
language = "English (US)",
volume = "14",
pages = "514--520",
journal = "American Journal of Managed Care",
issn = "1088-0224",
publisher = "Ascend Media",
number = "8",

}

TY - JOUR

T1 - Managed care enrollment and chronically disabled women with breast cancer

AU - Habermann, Elizabeth B

AU - Virnig, Beth A.

AU - Durham, Sara B.

AU - Baxter, Nancy N.

PY - 2008/8

Y1 - 2008/8

N2 - Objective: To assess whether managed care enrollment or healthcare utilization level among women enrolled in Medicare because of disability affects stage at diagnosis and treatment of breast cancer. Study Design: Retrospective study using the Surveillance, Epidemiology, and End Results-Medicare database. We compared breast cancer stage at diagnosis and treatment among women with disabilities enrolled in Medicare managed care versus fee-for-service (FFS) Medicare. Women enrolled in FFS Medicare were classified into levels of healthcare utilization during the 6 to 18 months before breast cancer diagnosis. Methods: Controlling for confounders, we used regression models to determine the effects of managed care enrollment and healthcare utilization level on earlier stage at diagnosis and treatment of breast cancer. Results: Disabled patients enrolled in FFS Medicare without contact with the healthcare system and those with fewer than 12 physician visits during the 6 to 18 months before breast cancer diagnosis were more likely than disabled patients enrolled in Medicare managed care to be diagnosed as having breast cancer at a late stage. There was no difference between women enrolled in Medicare managed care versus women enrolled in FFS Medicare having at least 12 physician visits during the 12-month period. Breast cancer treatment for women with disabilities did not vary across managed care enrollment or healthcare utilization level. Conclusion: Managed care enrollment or increased contact with healthcare providers could result in earlier stage at breast cancer diagnosis.

AB - Objective: To assess whether managed care enrollment or healthcare utilization level among women enrolled in Medicare because of disability affects stage at diagnosis and treatment of breast cancer. Study Design: Retrospective study using the Surveillance, Epidemiology, and End Results-Medicare database. We compared breast cancer stage at diagnosis and treatment among women with disabilities enrolled in Medicare managed care versus fee-for-service (FFS) Medicare. Women enrolled in FFS Medicare were classified into levels of healthcare utilization during the 6 to 18 months before breast cancer diagnosis. Methods: Controlling for confounders, we used regression models to determine the effects of managed care enrollment and healthcare utilization level on earlier stage at diagnosis and treatment of breast cancer. Results: Disabled patients enrolled in FFS Medicare without contact with the healthcare system and those with fewer than 12 physician visits during the 6 to 18 months before breast cancer diagnosis were more likely than disabled patients enrolled in Medicare managed care to be diagnosed as having breast cancer at a late stage. There was no difference between women enrolled in Medicare managed care versus women enrolled in FFS Medicare having at least 12 physician visits during the 12-month period. Breast cancer treatment for women with disabilities did not vary across managed care enrollment or healthcare utilization level. Conclusion: Managed care enrollment or increased contact with healthcare providers could result in earlier stage at breast cancer diagnosis.

UR - http://www.scopus.com/inward/record.url?scp=49749092146&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49749092146&partnerID=8YFLogxK

M3 - Article

C2 - 18690767

AN - SCOPUS:49749092146

VL - 14

SP - 514

EP - 520

JO - American Journal of Managed Care

JF - American Journal of Managed Care

SN - 1088-0224

IS - 8

ER -