Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Am J Manag Care. 2004 Feb;10(2 Pt 1):99-107.

Does patient cost sharing matter? Its impact on recommended versus controversial cancer screening services.

Author information

  • 1University of California, 3333 California St., Suite 420, Box 0613, San Francisco, CA 94143, USA. sliang@itsa.ucsf.edu

Abstract

OBJECTIVES:

To examine whether there are differential impacts of patient cost sharing and health plan organizational characteristics on the use of a recommended cancer screening service (mammography) versus a controversial cancer screening service (prostate cancer screening [PCS]).

STUDY DESIGN:

Observational cohort using the 1996 Medical Expenditure Panel Survey.

PATIENTS AND METHODS:

A nationally representative sample of privately insured individuals was examined. Outcome measures were the receipt of mammography and PCS. Logistic regression was used to assess the impact of patient cost sharing and health plan organizational characteristics on the receipt of mammography and PCS, controlling for other covariates.

RESULTS:

Patient cost sharing and gatekeeper requirements were strong predictors of PCS but were statistically insignificant predictors of mammography. Men in health plans with a copayment over dollar 10 (odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.19-0.78) or with deductibles over dollar 250 (OR = 0.38, 95% CI = 0.23-0.62) were significantly less likely to receive PCS than men in plans with no or lower copayments and deductibles. Men in gatekeeper plans were less likely to receive PCS than those without gatekeepers (OR = 0.48, 95% CI = 0.29-0.81).

CONCLUSIONS:

We found the impact of cost sharing on utilization is different between mammography and PCS. Prostate cancer screening utilization appears to respond to financial incentives while mammography utilization does not. The use of copayments, deductibles, and gatekeepers may discourage controversial services but may not have an adverse effect on more recommended services. These findings have implications for the design of insurance benefits and plan organizational structure.

PMID:
15011810
[PubMed - indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Managed Care & Healthcare Communications, LLC
    Loading ...
    Write to the Help Desk