scholarly journals The Influences of Health Insurance and Access to Information on Prostate Cancer Screening among Men in Dominican Republic

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Joseph Kangmennaang ◽  
Isaac Luginaah
Keyword(s):  
Prostate Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Dominican Republic ◽  
Prostate Cancer Screening ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Logit Regression ◽  
Binary Logit ◽  
Binary Logit Regression

Objectives.Although research demonstrates the public health burden of prostate cancer among men in the Caribbean, relatively little is known about the factors that underlie the low levels of testing for the disease among this population.Study Design.A cross-sectional study of prostate cancer testing behaviours among men aged 40–60 years in Dominican Republic using the Demographic and Health Survey (2013).Methods.We use hierarchical binary logit regression models and average treatment effects combined with propensity score matching to explore the determinants of prostate screening as well as the average effect of health insurance coverage on screening. The use of hierarchical binary logit regression enabled us to control for the effect of unobserved heterogeneity at the cluster level that may affect prostate cancer testing behaviours.Results.Screening varied significantly with health insurance coverage, knowledge of cholesterol level, education, and wealth. Insured men were more likely to test for prostate cancer (OR = 1.65,p=0.01) compared to the uninsured.Conclusions.The expansion and restructuring of Dominican Republic universal health insurance scheme to ensure equity in access may improve health access that would potentially impact positively on prostate cancer screening among men.

scholarly journals What Prevents Men Aged 40–64 Years from Prostate Cancer Screening in Namibia?

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Joseph Kangmennaang ◽  
Paul Mkandawire ◽  
Isaac Luginaah
Keyword(s):  
Prostate Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Unobserved Heterogeneity ◽  
Prostate Cancer Screening ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Local Context ◽  
Negative Consequences ◽  
Public Health Burden

Objectives. Although a growing body of evidence demonstrates the public health burden of prostate cancer in SSA, relatively little is known about the underlying factors surrounding the low levels of testing for the disease in the context of this region. Using Namibia Demographic Health Survey dataset (NDHS, 2013), we examined the factors that influence men’s decision to screen for prostate cancer in Namibia.Methods. We use complementary log-log regression models to explore the determinants of screening for prostate cancer. We also corrected for the effect of unobserved heterogeneity that may affect screening behaviours at the cluster level.Results. The results show that health insurance coverage (OR = 2.95,p=0.01) is an important predictor of screening for prostate cancer in Namibia. In addition, higher education and discussing reproductive issues with a health worker (OR = 2.02,p=0.05) were more likely to screening for prostate cancer.Conclusions. A universal health insurance scheme may be necessary to increase uptake of prostate cancer screening. However it needs to be acknowledged that expanded screening can have negative consequences and any allocation of scarce resources towards screening must be guided by evidence obtained from the local context about the costs and benefits of screening.

scholarly journals The Impact of Medicare Health Insurance Coverage on Lung Cancer Screening

Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jiren Sun ◽  
Marcelo Coca Perraillon ◽  
Rebecca Myerson
Keyword(s):  
Lung Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Insurance Coverage ◽  
Lung Cancer Screening ◽  
Health Insurance Coverage ◽  
The Impact

Impact of sexual orientation on contemporary rates of prostate cancer screening.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 122-122
Author(s):  
Daniel Pucheril ◽  
Matthew D. Ingham ◽  
Dimitar V. Zlatev ◽  
Sebastian Berg ◽  
Matthew Mossanen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sexual Orientation ◽  
Cancer Screening ◽  
Sexual Minorities ◽  
College Graduates ◽  
Prostate Cancer Screening ◽  
Insurance Coverage ◽  
Multivariable Analysis ◽  
Independent Effect ◽  
Behavioral Risk

122 Background: Despite increasing societal acceptance of non-heterosexual persons, sexual minorities continue to face discrimination. The effect of non-heterosexual orientation on adoption of cancer preventive services, particularly prostate cancer screening (PSAS), is not clearly known. We hypothesize that male sexual minorities are less likely to receive PSAS compared to heterosexual (HTS) males. Methods: The 2014-16 Behavioral Risk Factor Surveillance System was queried for males 40-69, without a history of prostate cancer, and having answered all sexual orientation (SO) questions. PSAS occurred if a respondent had a PSA test within the last two years for reasons other than “a prostate problem” or “for prostate cancer”. Descriptive statistics were generated for demographic covariates stratified by year and SO [HTS, homosexual (HMS), bisexual (BIS), transgender (TGR), other, and refused]. The Chi-Square test was used to compare the distribution of covariate proportions amongst SO categories within each year. Multivariable regression was used to determine the independent effect of SO and other covariates on receipt of PSAS in this cohort. Results: A weighted 49.2 million individuals (n = 86,893) met inclusion criteria. In 2014 and 2016, 94% and 93% of the cohort identified as HTS. In both years, a higher proportion of HMS (2014: 40.5%, 2016: 47.4) and BIS (2014: 30.3%, 2016: 31.0%) respondents were college graduates compared to HTS males (2014: 28.8%, 2016: 28.9%). In 2014, rates of PSAS were higher amongst HMS (34.9%), BIS (37.1%) and TGR (37.5%) individuals compared to HTS individuals (34.5%). In 2016, rates of PSAS were clinically similar among HTS (30.4%), HMS (30.2%), BIS (30.1%), and TGR (27.8%) individuals. In the multivariable analysis, increasing age (65-69 OR 8.93, 95%CI 7.80-10.22) and education level (College Graduate OR 2.21, 95%CI 1.93-2.54) along with insurance coverage (OR 2.15, 95%CI 1.85-2.51) and a personal physician (OR 2.88, 95%CI 2.59-3.20) were associated with higher odds of PSAS. Aside from HMS orientation (OR 1.30, 95%CI 1.04-1.62), SO was not an independent predictor of PSAS. Conclusions: Based on this nationally representative sample, disparities in regards to PSAS are not apparent for non-HTS males.

scholarly journals Influence of health insurance coverage on breast, cervical, and colorectal cancer screening in rural primary care settings

Cancer ◽  
2012 ◽  
Vol 118 (24) ◽  
pp. 6217-6225 ◽  
Author(s):  
Patricia A. Carney ◽  
Jean O'Malley ◽  
David I. Buckley ◽  
Motomi Mori ◽  
David A. Lieberman ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Health Insurance ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Rural Primary Care ◽  
Primary Care Settings

Impact of late Medicaid expansion on prostate cancer screening.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 141-141 ◽  
Author(s):  
Daniel Pucheril ◽  
Dimitar V. Zlatev ◽  
Matthew Mossanen ◽  
Alexander P Cole ◽  
Matthew D. Ingham ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Behavioral Risk ◽  
Medicaid Expansion ◽  
Poverty Level ◽  
Multivariable Logistic Regression Model ◽  
Significant Difference ◽  
Personal Physician

141 Background: A key provision of the Affordable Care Act (ACA) was the expansion of Medicaid to childless adults living < 138% of the federal poverty level (FPL). Aside from a few early expansion states, the majority of states adopting the provision expanded coverage in January 2014, and are categorized as late expansion states (LES). Non-expansion states (NES) opposed expansion and did not adopt these broader provisions. Our objective was to determine the effects of this policy change on prostate cancer screening (PSAS) trends in LES and NES. Methods: The 2014 and 2016 Behavioral Risk Factor Surveillance System surveys reflect 2013 and 2015 health behaviors, and were queried for men 40-64, without history of prostate cancer, with a household income < 138% FPL, and residing in NES or LES. Descriptive statistics, stratified by expansion status and year, were generated for covariates. The Chi-Square test was used to compare proportions between years within state categories. Difference-in-differences (DID) analyses were employed to compare trends in men with health insurance, a personal physician, and undergoing PSAS. Within a multivariable logistic regression model, the interaction term year*state expansion status was used to determine the significance of DID estimates. Results: A weighted 8.8 million (n = 14,979) men met inclusion criteria. PSAS significantly declined from 2014 to 2016 in both NES (22.6% to 16.4%, p = 0.0006) and LES (20.5% to 15.8%, p = 0.003). In LES, the proportion of men with health insurance significantly increased from 2014 to 2016 (75.5% to 82.7%, p = 0.0002), however the proportion of insured men in NES was constant. Additionally, the proportion of respondents with a personal physician was unchanged from 2014 to 2016 in both NES and LES. DID analysis determined a significant difference in health insurance trends between 2014 and 2016 for LES compared to NES (+6.9%, p = 0.008). DID estimates were not significant for comparisons of trends for PSAS or access to a personal physician. Conclusions: The ACA’s Medicaid expansion provision has led to significant gains in insurance coverage for eligible persons in LES compared to NES, however, these gains have not translated into significantly different rates of access to a personal physician or PSAS.

scholarly journals Health Insurance Coverage Mandates: Colorectal Cancer Screening in the Post-ACA Era

2020 ◽  
Vol 14 (1) ◽  
pp. 123-130
Author(s):  
Michael A. Preston ◽  
Levi Ross ◽  
Askar Chukmaitov ◽  
Sharla A. Smith ◽  
Michelle L. Odlum ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Insurance Coverage ◽  
Health Insurance Coverage

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.

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