Impact of Health Insurance, Poverty, and Comorbidities on Colorectal Cancer Screening: Insights from the Medical Expenditure Panel Survey

Gawron, Andrew J.; Staub, Judith; Bielefeldt, Klaus

doi:10.1007/s10620-020-06541-7

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…Another notable result was that the number of reported chronic diseases was a favorable predictor of FIT uptake. This is consistent with previous research ( 37 ). While our findings are likely to be the result of more encounters with providers and therefore more opportunities to perform the suggested screening procedures, it is plausible that individuals with chronic illnesses may experience a significant treatment and self-management load, which may in turn lead to a refusal to participate in healthcare interventions which are not directly associated with their primary disorder ( 38 ).…”

Section: Discussionsupporting

confidence: 94%

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Cruz

Cebrino

2023

Front. Public Health

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BackgroundAlthough population screening has improved the early diagnosis of colorectal cancer (CRC), most cases are diagnosed in symptomatic patients. This study aimed to estimate the prevalence and evolution over time of uptake patterns to fecal immunochemical test (FIT) as a screening test for CRC among individuals aged 50–69 in Spain, and to determine the predictive factors for uptake patterns to this type of screening based on sociodemographic, health, and lifestyle characteristics.MethodsA cross-sectional study with 14,163 individuals from the 2017 Spanish National Health Survey and the 2020 European Health Survey was performed, including as the main variable uptake pattern to FIT screening within the last 2 years, with which we analyzed sociodemographic factors, health status and lifestyle habits.Results38.01% of participants had undergone FIT in the previous 2 years, and from 2017 to 2020, a significant increase in the uptake rate for CRC was observed (2017: 32.35%, 2020: 43.92%, p < 0.001). The positive predictors to FIT uptake pattern included factors such as being between 57 and 69 years, having a higher educational level or a higher social class, having at least one chronic illness, frequent contact with the primary care physician, alcohol consumption and physical activity, while immigration and smoking habit were negative predictors.ConclusionIn Spain, although the evolution of FIT uptake pattern over time is positive, the prevalence of FIT uptake is still low (38.01%), not reaching the level considered as acceptable in the European guidelines. Moreover, there are disparities in CRC screening uptake among individuals.

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Section: Discussionsupporting

confidence: 94%

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Cruz

Cebrino

2023

Front. Public Health

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“…Pairwise correlations were checked between all independent variables prior to model building with a preset model exclusion threshold correlation coefficient = 0.05. Independent variables were selected a priori based on correlates of CRC screening in the literature [ 28 , 29 ]. Further, as a sensitivity analysis, pharmacy-specific variables such as pharmacy quality scale, type of pharmacy, and method used to pick up prescriptions were removed from the model to test impact on demographic characteristic estimates.…”

Section: Methodsmentioning

confidence: 99%

Patient preferences for the design of a pharmacy-based colorectal cancer screening program

Brenner

Waters

Wangen

et al. 2023

Cancer Causes Control

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Purpose To assess preferences for design of a pharmacy-based colorectal cancer (CRC) screening program (PharmFIT™) among screening-eligible adults in the United States (US) and explore the impact of rurality on pharmacy use patterns (e.g., pharmacy type, prescription pick-up preference, service quality rating). Methods We conducted a national online survey of non-institutionalized US adults through panels managed by Qualtrics, a survey research company. A total of 1,045 adults (response rate 62%) completed the survey between March and April 2021. Sampling quotas matched respondents to the 2010 US Census and oversampled rural residents. We assessed pharmacy use patterns by rurality and design preferences for learning about PharmFIT™; receiving a FIT kit from a pharmacy; and completing and returning the FIT kit. Results Pharmacy use patterns varied, with some notable differences across rurality. Rural respondents used local, independently owned pharmacies more than non-rural respondents (20.4%, 6.3%, p < 0.001) and rated pharmacy service quality higher than non-rural respondents. Non-rural respondents preferred digital communication to learn about PharmFIT™ (36% vs 47%; p < 0.001) as well as digital FIT counseling (41% vs 49%; p = 0.02) more frequently than rural participants. Preferences for receiving and returning FITs were associated with pharmacy use patterns: respondents who pick up prescriptions in-person preferred to get their FIT (OR 7.7; 5.3–11.2) and return it in-person at the pharmacy (OR 1.7; 1.1–2.4). Conclusion Pharmacies are highly accessible and could be useful for expanding access to CRC screening services. Local context and pharmacy use patterns should be considered in the design and implementation of PharmFIT™.

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“…MEPS is a set of surveys that collects data on health services that people use, their costs, payers, health insurance status of participants, and related data to generate nationally representative estimates of health care costs (the sum of direct payments for health care provided during the year) 22 for the civilian, noninstitutionalized population. [23][24][25][26][27] We used the MEPS Household Component and Condition files. The former is drawn from households that participated in the previous year's National Health Interview Survey.…”

Section: Data Sources and Sampling Approachmentioning

confidence: 99%

Drivers of US health care spending for persons with seizures and/or epilepsies, 2010–2018

et al. 2022

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Objective: This study was undertaken to characterize spending for persons classified with seizure or epilepsy and to determine whether spending has increased over time. Methods:In this cross-sectional study, we pooled data from the Medical Expenditure Panel Survey (MEPS) household component files for 2010-2018. We matched cases to controls on age and sex of a population-based sample of MEPS respondents (community-dwelling persons of all ages) with records associated with a medical event (e.g., outpatient visit, hospital inpatient) for seizure, epilepsy, or both. Outcomes were weighted to be representative of the civilian, noninstitutionalized population. We estimated the treated prevalence of epilepsy and seizure, health care spending overall and by site of care, and trends in spending growth. Results:We identified 1078 epilepsy cases and 2344 seizure cases. Treated prevalence was .38% (95% confidence interval [CI] = .34-.41) for epilepsy, .

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Impact of Health Insurance, Poverty, and Comorbidities on Colorectal Cancer Screening: Insights from the Medical Expenditure Panel Survey

Cited by 11 publications

References 15 publications

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Patient preferences for the design of a pharmacy-based colorectal cancer screening program

Drivers of US health care spending for persons with seizures and/or epilepsies, 2010–2018

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