Personalized targeted mailing increases mammography among long-term noncompliant medicare beneficiaries: a randomized trial
| Autor: | Laurence F. McMahon, R. Van Harrison, Philip J. Tedeschi, Michael E. Chernew, Xuelin Huang, Nancy K. Janz, Robert A. Wolfe, Jeoffrey K. Stross |
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| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
Michigan Reminder Systems Breast Neoplasms Medicare law.invention Treatment Refusal Breast cancer screening Randomized controlled trial law Medicine Mammography Humans skin and connective tissue diseases health care economics and organizations Aged Aged 80 and over medicine.diagnostic_test business.industry Public Health Environmental and Occupational Health Medicare beneficiary Patient Acceptance of Health Care Intervention studies United States Family medicine Social Marketing Physical therapy Female Mammography screening business |
| Zdroj: | Medical care. 41(3) |
| ISSN: | 0025-7079 |
| Popis: | The study purpose was to increase mammography screening among older women by identifying female Medicare beneficiaries without a recent mammogram and assesses the cost-effectiveness of a personalized targeted mailing encouraging them to have a mammogram.A randomized paired controlled trial included 1229 pairs of women matched on zip code, race, and urban or rural county. Postintervention mammography claims were measured from November 1997 through December 1998. The subjects were female Medicare beneficiaries ageor = 70, living in Michigan foror = 5 years, having no significant comorbidity likely to affect screening, and no mammogram foror = 5 years. Intervention subjects received a personally addressed letter from the Medical Director of Michigan Medicare with materials emphasizing the individual's lack of use of the Medicare mammography screening benefit, reasons for screening, and how to be screened.Women who received the mailing were 60% more likely to have a subsequent mammogram (OR 1.6, P0.005), with diagnostic mammograms increasing more than screening mammograms (2.8% vs. 0.8%). The absolute increase was greatest for women age 70 to 79, 10.6% in the intervention group versus 6.5% for controls, odds ratio 1.7 (P0.02). A statewide Medicare intervention in Michigan would cost of 108,000 US dollars to 238,000 US dollars, producing 3500 to 4300 additional mammograms at 31 US dollars to 55 US dollars per additional mammogram.The intervention increased mammography among long-term noncompliant older women, particularly increasing diagnostic mammograms. This approach can be directly implemented in other states and nationally. It may also be useful for other preventive services. |
| Databáze: | OpenAIRE |
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