Health care reform and women's insurance coverage for breast and cervical cancer screening.
Health care reform and women's insurance coverage for breast and cervical cancer screening.
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DOI：
10.5888/pcd9.120069
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发表时间：
2012
影响因子：
5.5
通讯作者：
Ku L
中科院分区：
文献类型：
--
作者：
Levy AR;Bruen BK;Ku L
2010 年患者保护和平价医疗法案 (ACA) 将通过保险范围扩大和监管改革，增加美国公民以及乳腺癌和宫颈癌筛查的保险覆盖范围。本研究的主要目的是估计实施平价医疗法案后将获得健康保险从而能够进行癌症筛查的低收入女性人数。第二个目标是估计未参保低收入人口的规模和特征，以及仍需要国家乳腺癌和宫颈癌早期检测计划 (NBCCEDP) 服务的妇女人数。我们利用具有全国代表性的 2009 年美国社区调查来估计马萨诸塞州妇女保险状况的决定因素，假设全面实施《平价医疗法案》。我们推断结果来模拟平价医疗法案对每个州的影响。我们使用个人层面的未保险预测概率来估算实施 ACA 后将获得健康保险的女性人数，并预测对 NBCCEDP 服务的需求。大约 680 万低收入妇女将获得健康保险，这可能会增加癌症筛查的年度需求，最初增加约 50 万次乳房 X 光检查和 130 万次巴氏检查。尽管低收入未参保妇女人数减少了 60%，但 NBCCEDP 所服务的妇女人数仍不足预计有资格获得服务的妇女人数的三分之一。符合 NBCCEDP 资格的人群将包括大量存在语言和识字相关护理障碍的妇女。 ACA 的实施将增加数百万女性的保险覆盖范围和癌症筛查的机会，但 NBCCEDP 对于数百万仍没有保险的女性来说仍然至关重要。
The Patient Protection and Affordable Care Act of 2010 (ACA) will increase insurance coverage for US citizens and for breast and cervical cancer screening through insurance expansions and regulatory changes. The primary objective of this study was to estimate the number of low-income women who would gain health insurance after implementation of the ACA and thus be able to obtain cancer screening. A secondary objective was to estimate the size and characteristics of the uninsured low-income population and the number of women who would still need National Breast and Cervical Cancer Early Detection Program (NBCCEDP) services. We used the nationally representative 2009 American Community Survey to estimate the determinants of insurance status for women in Massachusetts, assuming full implementation of the ACA. We extrapolated findings to simulate the effects of the ACA on each state. We used individual-level predicted probabilities of being uninsured to generate estimates of the number of women who would gain health insurance after implementation of the ACA and to predict demand for NBCCEDP services. Approximately 6.8 million low-income women would gain health insurance, potentially increasing the annual demand for cancer screenings initially by about 500,000 mammograms and 1.3 million Papanicolaou tests. Despite a 60% decrease in the number of low-income uninsured women, the NBCCEDP would still serve fewer than one-third of the estimated number of women eligible for services. The NBCCEDP-eligible population would comprise a larger number of women with language and literacy-related barriers to care. Implementation of the ACA would increase insurance coverage and access to cancer screening for millions of women, but the NBCCEDP will remain essential for the millions who will remain uninsured.
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DOI：
10.5034/inquiryjrnl_43.1.66
发表时间：
2006-03-01
影响因子：
1.7
作者：
Ponce, Ninez A.;Ku, Leighton;Brown, E. Richard
通讯作者：
Brown, E. Richard
影响因子：
12.7
作者：
Richardson, Lisa C.;Royalty, Janet;Benard, Vicki B.
通讯作者：
Benard, Vicki B.
影响因子：
6.2
作者：
Breen, Nancy;Gentleman, Jane F.;Schiller, Jeannine S.
通讯作者：
Schiller, Jeannine S.
影响因子：
5.1
作者：
Hewitt, M;Devesa, SS;Breen, N
通讯作者：
Breen, N
影响因子：
2.3
作者：
Meissner, Helen I.;Breen, Nancy;Graubard, Barry I.
通讯作者：
Graubard, Barry I.