Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50

Autor: Stephanie B. Wheeler, Tzy-Mey Kuo, Anne Marie Meyer, Christa E. Martens, Kristen M. Hassmiller Lich, Florence K.L. Tangka, Lisa C. Richardson, Ingrid J. Hall, Judith Lee Smith, Maria E. Mayorga, Paul Brown, Trisha M. Crutchfield, Michael P. Pignone
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Preventive Medicine Reports, Vol 6, Iss C, Pp 9-16 (2017)
Druh dokumentu: article
ISSN: 2211-3355
DOI: 10.1016/j.pmedr.2016.11.019
Popis: Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes. Person-level and county-level contextual variables were included in multilevel random intercepts models to understand predictors of CRC test modality, stratified by insurance type. Of 12,570 publicly-insured persons turning 50 during the study period who received CRC testing, 57% received colonoscopy, whereas 43% received FOBT/FIT, with significant regional variation. In multivariable models, females with public insurance had lower odds of colonoscopy than males (odds ratio [OR] = 0.68; p
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