Comparative Effectiveness of Health Insurance Reform on Cancer Disparities

描述（由申请人提供）： 此应用程序解决了广泛的挑战领域（05）比较有效性研究和特定的挑战主题05-MD-101*，健康的社会决定因素。我们建议进行比较效果分析和成本效益分析，以调查健康保险改革对解决癌症健康差距的好处。癌症健康差异的社会决定因素已经描述，其中包括获得优质医疗保健和保险支付优质护理。有必要调查公共卫生政策的相对有效性，这些政策通过改善医疗保险作为克服癌症健康差异的社会决定因素的机制，改善了医疗保健的获得和质量。具体来说，我们建议调查的比较和成本效益的健康保险改革，是在2006年在联邦马萨诸塞州，对癌症的结果传统上服务不足的妇女有异常的宫颈癌和乳腺癌筛查研究。我们建议使用我们的研究小组作为波士顿大学患者导航研究计划的一部分收集的独特数据库进行这项分析。我们收集了详细的临床，人口统计学，保险和结果数据超过3300名妇女，整个队列的妇女异常乳腺癌和宫颈癌筛查研究2004-5和2007-9在6个社区卫生中心在波士顿。我们提出的研究在方法和解决方法的数据集方面都是独一无二的。我们收集了医疗保险改革特别寻求支持的一个完整的妇女临床队列的数据。该数据集能够观察马萨诸塞州健康保险改革的“自然实验”的结果，因为我们在保险改革前2年开始收集数据，并在其实施后持续2年。由于许多人期待马萨诸塞州的经验，以制定一个国家健康保险计划，我们的研究有重大影响的国家政策的潜力。迫切需要关于医疗保险改革的临床影响的经验数据。我们的研究结果将提供经验得出的比较有效性的数据，是至关重要的利益，以政策制定者在当地和全国寻求评估保险改革的好处。我们建议调查的比较和成本效益的健康保险改革，是在2006年制定的联邦马萨诸塞州，对癌症的结果，传统上服务不足的妇女有异常的宫颈癌和乳腺癌筛查研究。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (05) Comparative Effectiveness Research and specific Challenge Topic 05-MD-101*, Social Determinants of Health. We propose to conduct a comparative effectiveness analysis and cost effectiveness analysis to investigate the benefit of health insurance reform on addressing cancer health disparities. The social determinants of cancer health disparities have been described, which include access to quality health care, and insurance to pay for quality care. There is a need to investigate the comparative effectiveness of public health policies that improve access and quality of health care through improvements in health insurance as a mechanism to overcome social determinants of cancer health disparities. Specifically, we propose to investigate the comparative and cost effectiveness of health insurance reform that was instituted in 2006 in the Commonwealth of Massachusetts, on the cancer outcomes of traditionally underserved women who have abnormal cervical and breast cancer screening studies. We propose to conduct this analysis using a unique database our research group has collected as part of the Boston University Patient Navigation Research Program. We have collected detailed clinical, demographic, insurance, and outcome data on over 3300 women, the entire cohort of women with abnormal breast and cervical cancer screening studies between 2004-5 and 2007-9 at 6 community health centers in Boston. Our proposed research is unique both in its approach and in the dataset to address the approach. We have collected data on a complete clinical cohort of women that health insurance reform specifically seeks to support. This dataset has the ability to observe the findings of the "natural experiment" of Massachusetts Health Insurance Reform, in that we began our data collection 2 years prior to insurance reform, and continued 2 years after its implementation. As many look to the Massachusetts experience to develop a national health insurance plan, our research has major impact potential on national policy. There is a critical need for empiric data on the clinical impact of health insurance reform. Our results will provide empirically derived comparative effectiveness data that is of critical interest to policy makers locally and nationally seeking to assess the benefits of insurance reform. We propose to investigate the comparative and cost effectiveness of health insurance reform that was instituted in 2006 in the Commonwealth of Massachusetts, on the cancer outcomes of traditionally underserved women who have abnormal cervical and breast cancer screening studies.