Impact of insurance type on survivor-focused and general preventive health care utilization in adult survivors of childhood cancer: the Childhood Cancer Survivor Study (CCSS).
Impact of insurance type on survivor-focused and general preventive health care utilization in adult survivors of childhood cancer: the Childhood Cancer Survivor Study (CCSS).
复制标题
DOI：
10.1002/cncr.25688
复制
发表时间：
2011-05-01
期刊：
影响因子：
6.2
通讯作者：
Oeffinger, Kevin C.
中科院分区：
文献类型：
--
作者：
Casillas, Jacqueline;Castellino, Sharon M.;Hudson, Melissa M.;Mertens, Ann C.;Lima, Isac S. F.;Liu, Qi;Zeltzer, Lonnie K.;Yasui, Yutaka;Robison, Leslie L.;Oeffinger, Kevin C.
关键词：
缺乏健康保险是获得慢性病和癌症筛查护理的一个主要障碍。我们研究了保险类型（私人，公共，无）对儿童癌症成年幸存者以幸存者为中心的一般预防性医疗保健的影响。儿童癌症幸存者研究是对1970-1986年间诊断的儿童癌症幸存者进行的回顾性队列研究。在8425名成年幸存者中，估计了未保险（n=1390）和公共保险（n=640）与私人保险（n = 6395）相比，接受以幸存者为中心的预防保健和一般预防保健的相对危险度（RR）和95%置信区间（CI）。没有保险的幸存者报告癌症相关（调整后的RR=0.83，95%CI，0.75-0.91）或癌症中心就诊（调整后的RR=0.83，95%CI，0.71-0.98）的可能性低于私人保险。与私人保险相比，未投保的幸存者在所有护理措施方面的利用率较低。相比之下，公共保险幸存者更有可能报告癌症相关（调整后的RR=1.22，95% CI，1.11-1.35）或癌症中心访问（调整后的RR=1.41，95% CI，1.18-1.70）比私人保险。虽然一般健康检查的利用率相似，但公共保险幸存者报告巴氏涂片或牙科检查的可能性较小。在这个庞大的、社会经济多样化的群体中，有公共保险的幸存者利用以幸存者为重点的医疗保健的比率至少与有私人保险的幸存者一样高。未投保的幸存者对以幸存者为重点的和一般预防性保健的利用率较低。
Lack of health insurance is a key barrier to accessing care for chronic conditions and cancer screening. We examined the influence of insurance type (private, public, none) on survivor-focused and general preventive health care in adult survivors of childhood cancer. The Childhood Cancer Survivor Study is a retrospective cohort study of childhood cancer survivors diagnosed between 1970–1986. Among 8425 adult survivors, the Relative Risk (RR), 95% confidence interval (CI) of receiving survivor-focused and general preventive health care were estimated for uninsured (n=1390) and publicly insured (n=640), comparing to privately insured (n=6395). Uninsured survivors were less likely than privately insured to report a cancer-related (adjusted RR=0.83, 95% CI, 0.75–0.91) or a cancer center visit (adjusted RR=0.83, 95% CI, 0.71–0.98). Uninsured survivors had lower levels of utilization in all measures of care in comparison with privately insured. In contrast, publicly insured survivors were more likely to report a cancer-related (adjusted RR=1.22, 95% CI, 1.11–1.35) or a cancer center visit (adjusted RR=1.41, 95% CI, 1.18–1.70) than privately insured. While having a similar utilization level of general health examinations, publicly insured survivors were less likely to report Papanicolaou smear or dental examinations. Among this large, socioeconomically diverse cohort, publicly insured survivors utilize survivor-focused health care at rates at least as high as survivors with private insurance. Uninsured survivors have lower utilization to both survivor-focused and general preventive health care.
登录
查看更多内容
影响因子：
45.3
作者：
Goss, Elizabeth;Lopez, Ana Maria;Raghavan, Derek
通讯作者：
Raghavan, Derek
影响因子：
6.2
作者：
Kandula, Namratha R.;Wen, Ming;Lauderdale, Diane S.
通讯作者：
Lauderdale, Diane S.
影响因子：
158.5
作者：
AYANIAN, JZ;KOHLER, BA;EPSTEIN, AM
通讯作者：
EPSTEIN, AM
影响因子：
1.7
作者：
Cubukcu, Cigdem Elbek;Sevinir, Betuel
通讯作者：
Sevinir, Betuel
影响因子：
120.7
作者：
KAHN, KL;PEARSON, ML;KEELER, EB
通讯作者：
KEELER, EB