Experimental Breast Cancer Treatments and Health Insurance Coverage

2007 ◽  
Vol 9 (1) ◽  
pp. 34-37 ◽  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cancer Treatments

scholarly journals Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bonita Salmeron ◽  
Lohuwa Mamudu ◽  
Xiaohui Liu ◽  
Martin Whiteside ◽  
Faustine Williams
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Health Insurance ◽  
Marital Status ◽  
Cancer Registry ◽  
Cancer Incidence ◽  
Insurance Coverage ◽  
Breast Cancer Incidence ◽  
Health Insurance Coverage ◽  
Geographic Differences

Abstract Background Tennessee women experience the 12th highest breast cancer mortality in the United States. We examined the geographic differences in breast cancer incidence in Tennessee between Appalachian and non-Appalachian counties from 2005 to 2015. Methods We used ArcGIS 10.7 geospatial analysis and logistic regression on the Tennessee Cancer Registry incidence data for adult women aged ≥ 18 years (N = 59,287) who were diagnosed with breast cancer from 2005 to 2015 to evaluate distribution patterns by Appalachian county designation. The Tennessee Cancer Registry is a population-based, central cancer registry serving the citizens of Tennessee and was established by Tennessee law to collect and monitor cancer incidence. The main outcome was breast cancer stage at diagnosis. Independent variables were age, race, marital status, type of health insurance, and county of residence. Results Majority of the sample were White (85.5%), married (58.6%), aged ≥ 70 (31.3%) and diagnosed with an early stage breast cancer (69.6%). More than half of the women had public health insurance (54.2%), followed by private health insurance coverage (44.4%). Over half of the women resided in non-Appalachian counties, whereas 47.6% were in the Appalachian counties. We observed a significant association among breast cancer patients with respect to marital status and type of health insurance coverage (p =  < 0.0001). While the logistic regression did not show a significant result between county of residence and breast cancer incidence, the spatial analysis revealed geographic differences between Appalachian and non-Appalachian counties. The highest incidence rates of 997.49–1164.59/100,000 were reported in 6 Appalachian counties (Anderson, Blount, Knox, Rhea, Roane, and Van Buren) compared to 3 non-Appalachian counties (Fayette, Marshall, and Williamson). Conclusions There is a need to expand resources in Appalachian Tennessee to enhance breast cancer screening and early detection. Using geospatial techniques can further elucidate disparities that may be overlooked in conventional linear analyses to improve women’s cancer health and associated outcomes.

scholarly journals How government health insurance coverage of novel anti-cancer medicines benefited patients in China – a retrospective analysis of hospital clinical data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yifan Diao ◽  
Mengbo Lin ◽  
Kai Xu ◽  
Ji Huang ◽  
Xiongwei Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Regression Model ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Government Health ◽  
Anti Cancer ◽  
The Government ◽  
Medication Choice

Abstract Background China started to cover novel medicines for the treatment of major cancers, such as trastuzumab for breast cancer by the government health insurance programs since 2016. Limited data have been published on the use of cancer medications and little is known about how government health insurance coverage of novel anti-cancer medicines benefited patients in the real world. This study aimed to generate evidence to inform the health security authorities to optimize the government health insurance coverage of novel anti-cancer medicines as a more inclusive and equal policy, through which each of the needed patient can get access to the novel anti-cancer medicines regardless of the ability to pay. Methods The study targeted one of the government health insurance newly covered novel medicines for breast cancer and the breast cancer patients. The analyses were based on the data collected from one tertiary public hospital in Fujian province of China. We conducted interrupted time series analysis with a segmented regression model and multivariate analyses with a binary logistic regression model to analyze the impact of the government health insurance coverage on medicines utilization and the determinants of patient’s medication choice. Results The average proportion of patients who initiated medication with novel medicines increased from 37.4% before the government health insurance coverage to 69.2% afterwards. Such an increase was observed in all patient sub-groups. The monthly proportion of patients who initiated medication with novel medicines increased sharply by 18.3 % (95 %CI,10.4-34.0 %, p = 0.01) in September 2017, the afterwards trend continuously increased (95 %CI,1.03–3.60, p = 0.02). The critical determinants of patient's medication choice were mostly connected with the patient's health insurance benefits packages. Conclusions The government health insurance coverage of novel anti-breast-cancer medicines benefited the patients generally. The utilization of novel medicines such as trastuzumab continuously increased. The insurance coverage benefited well the patients in the high-risk age groups. However, rural patients, patients enrolled in the “resident program”, and patients from low-income residential areas and non-local patients benefited less from this policy. Improving the benefits package of the low-income patients and the “resident program” beneficiary would be of considerable significance for a more inclusive and equal health insurance coverage of novel anti-cancer medicines.

scholarly journals Assessment of clinical outcome and health insurance coverage among patients with breast cancer

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Michael Addo Kwabeng ◽  
Kofi Adesi Kyei ◽  
Stephen Manortey ◽  
Verna Vanderpuye ◽  
Doris Kitson-Mills ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Survival Rate ◽  
Clinical Outcome ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Health Insurance Coverage ◽  
Health Concern ◽  
Breast Cancer Patients ◽  
Insurance Cover

Breast cancer is a global health concern in terms of morbidity and mortality. Risksharing mechanisms such as health insurance provide resources and promote access to healthcare. The aim of the study was to assess the relationship between health insurance coverage and clinical outcome of breast cancer patients. The study employed retrospective design involving the use of secondary data from the patients diagnosed with breast cancer. Between the period of 2015 to 2019, 250 patients’ records were reviewed from a sample size of 300 patients over 5 year patients’ follow-up period. A descriptive and Kaplan Meier survival analysis was performed to determine the patients’ survival rate. Seventy-two percent of the patients had health insurance cover at the time of diagnosis. Insurance status was found to be significantly associated with survival (p-values= 0.036). Insurance cover had 1.42 hazard ratio (p=0.036, 95% CI: 1.023-1.980). Patients with health insurance coverage at the time of diagnosis had a higher survival rate. No significant association was found among the demographic characteristics and the patients’ clinical outcomes.

Breast cancer screening among women in Namibia: explaining the effect of health insurance coverage and access to information on screening behaviours

2017 ◽  
Vol 26 (3) ◽  
pp. 50-61 ◽  
Author(s):  
Joseph Kangmennaang ◽  
Paul Mkandawire ◽  
Isaac Luginaah
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Insurance Coverage ◽  
Health Belief ◽  
Health Insurance Coverage ◽  
Nationally Representative ◽  
Belief Model ◽  
The Health Belief Model

Objectives: Breast cancer contributes substantially to morbidity and mortality in Namibia as is the case in most countries in Sub-Saharan Africa (SSA). However, there is a dearth of nationally representative studies that examine the odds of screening for breast cancer in Namibia and SSA at large. This paper aims to fill this gap by examining the determinants of breast cancer screening guided by the Health Belief Model. Methods: We applied hierarchical binary logit regression models to explore the determinants of breast cancer screening using the 2013 Namibia Demography and Health Survey (NDHS). We accounted for the effect of unobserved heterogeneity that may affect breast cancer, testing behaviours among women cluster level. The NDHS is a nationally representative dataset that has recently started to collect information on cancer screening. Results: The results show that women who have health insurance coverage (odds ratio (OR) = 1.62, p ≤ 0.01), maintain contact with health professionals (OR = 1.47, p = 0.01), and who have secondary (OR = 1.38, p = 0.01) and higher (OR = 1.77, p ≤ 0.01) education were more likely to be screened for breast cancer. Factors that influence women’s perception of their susceptibility to breast cancer such as birthing experience, age, region and place of residence were associated with screening in this context. Conclusions: Overall, the health belief model predicted women’s testing behaviours and also revealed the absence of relevant risk factors in the NDHS data that might influence screening. Overall, our results show that strategies for early diagnosis of breast cancer should be given major priority by cancer control boards as well as ministries of health in SSA. These strategies should centre on early screening and may involve reducing or eliminating barriers to health care, access to relevant health information and encouraging breast self-examination.

scholarly journals Changes in initiation of adjuvant endocrine therapy for breast cancer after state health reform

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Y. Eom ◽  
G. J. van Londen ◽  
Jie Li ◽  
Bassam Dahman ◽  
Cathy Bradley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Endocrine Therapy ◽  
Low Income ◽  
Health Reform ◽  
Insurance Coverage ◽  
Recurrence Risk ◽  
Health Insurance Coverage ◽  
Relative Increase ◽  
Adjuvant Endocrine Therapy

Abstract Background Socioeconomic differences in receipt of adjuvant treatment contribute to persistent disparities in breast cancer (BCA) outcomes, including survival. Adjuvant endocrine therapy (AET) substantially reduces recurrence risk and is recommended by clinical guidelines for nearly all women with hormone receptor-positive non-metastatic BCA. However, AET use among uninsured or underinsured populations has been understudied. The health reform implemented by the US state of Massachusetts in 2006 expanded health insurance coverage and increased the scope of benefits for many with coverage. This study examines changes in the initiation of AET among BCA patients in Massachusetts after the health reform. Methods We used Massachusetts Cancer Registry data from 2004 to 2013 for a sample of estrogen receptor (ER)-positive BCA surgical patients aged 20–64 years. We estimated multivariable regression models to assess differential changes in the likelihood initiating AET after Massachusetts health reform by area-level income, comparing women from lower- and higher-income ZIP codes in Massachusetts. Results There was a 5-percentage point (p-value< 0.001) relative increase in the likelihood of initiating AET among BCA patients aged 20–64 years in low-income areas, compared to higher-income areas, after the reform. The increase was more pronounced among younger patients aged 20–49 years (7.1-percentage point increase). Conclusions The expansion of health insurance in Massachusetts was associated with a significant relative increase in the likelihood of AET initiation among women in low-income areas compared with those in high-income areas. Our results suggest that expansions of health insurance coverage and improved access to care can increase the number of eligible patients initiating AET and may ameliorate socioeconomic disparities in BCA outcomes.

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