The impact of the affordable care act on breast cancer care in the USA: A multi‐institutional analysis

Maxwell, Jessica E.; Shats, Oleg; Aldridge, J. Wayne; Lyden, Elizabeth; Krie, Amy; Conklin, Richard M.; Manning, Kenneth; Fahed, Rabih; Vaziri, Irfan; Deveras, Ruby Anne E.; Mateen, Zubeena; Crow, Kate; Bjorling, Vince; Meschi, Joseph T.; Makoni, Stephen; Kruter, Flavio; Cowan, Kenneth H.

doi:10.1111/tbj.13373

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Although non-Medicaid expansion states like Alabama did not receive additional funding to expand women’s preventive services, many non-Medicaid expansion states still experienced an increase in insurance utilization following Medicaid-expansion, likely due to the increased awareness of insurance accessibility and importance of preventive healthcare initiatives popularized by the ACA [ 18 ]. In light of the central drive for Medicaid-expansion, if Alabama were to expand Medicaid, its citizens could experience increased insurance access and access to breast cancer screening modalities, incur lower incidences of late-stage breast cancer diagnoses, and become a more health-informed population [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Affordable Care Act provisions on the racial makeup of patients enrolled at a Deep South, high-risk breast cancer clinic

Tinglin,

McLeod,

Williams

et al. 2023

Preprint

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Purpose Black women are less likely to receive screening mammograms and are at a higher lifetime risk for developing breast cancer compared to their White counterparts. Affordable Care Act (ACA) provisions decreased cost sharing for women’s preventive screening, potentially mitigating screening disparities. We examined enrollment of a high-risk screening program before and after ACA implementation stratified by race. Methods This retrospective, quasi-experimental study examined the ACA’s impact on patient demographics at a high-risk breast cancer screening clinic from 02/28/2003–02/28/2019. Patient demographic data were abstracted from electronic medical records and descriptively compared in the pre- and post-ACA time periods. Interrupted time series (ITS) analysis using Poisson regression assessed yearly clinic enrollment rates by race using incidence rate ratios (IRR) and 95% confidence intervals (CI). Results 2,767 patients enrolled in the clinic. On average, patients were 46 years old (SD, ± 12), 82% were commercially insured, and 8% lived in a highly disadvantaged neighborhood. In ITS models accounting for trends over time, Prior to ACA implementation, White patient enrollment was stable (IRR 1.01, 95% CI 1.00-1.02) while Black patient enrollment increased at 13% per year (IRR 1.13, 95% CI 1.05–1.22). Compared to the pre-ACA enrollment period, the post-ACA enrollment rate remained unchanged for White patients (IRR 0.99, 95% CI 0.97–1.01) but decreased by 17% for Black patients (IRR 0.83, 95% CI 0.74–0.92). Conclusion Black patient enrollment decreased at a high-risk breast cancer screening clinic post-ACA compared to the pre-ACA period, indicating a need to identify factors contributing to racial disparities in clinic enrollment.

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Section: Discussionmentioning

confidence: 99%

Impact of Affordable Care Act provisions on the racial makeup of patients enrolled at a Deep South, high-risk breast cancer clinic

Tinglin,

McLeod,

Williams

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…The Affordable Care Act, which provided screening services to noninsured women, has helped women in groups with less access to screening mammography services by removing the financial barrier of health insurance. One study showed that after the Affordable Care Act was implemented, there was a trend toward more non-White patients and urban residents accessing breast cancer care [48]. Another vulnerable group, those with mental illness, were actually demonstrated to access mammography more than their non-mentally ill counterparts, unless they were Medicaid beneficiaries, in which case they experienced significant disadvantages in breast cancer screening [49].…”

Section: Breast Cancer Screeningmentioning

confidence: 99%

Health Care Disparities in Radiology—A Review of the Current Literature

DeBenedectis¹,

Spalluto²,

Americo³

et al. 2022

Journal of the American College of Radiology

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Introduction: Health care disparities exist in all medical specialties, including radiology. Raising awareness of established health care disparities is a critical component of radiology's efforts to mitigate disparities. Our primary objective is to perform a comprehensive review of the last 10 years of literature pertaining to disparities in radiology care. Our secondary objective is to raise awareness of disparities in radiology.Methods: We reviewed English-language medicine and health services literature from the past 10 years (2010-2020) for research that described disparities in any aspect of radiologic imaging using radiology search terms and key words for disparities in OVID. Relevant studies were identified with adherence to the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results:The search yielded a total 1,890 articles. We reviewed the citations and abstracts with the initial search yielding 1,890 articles (without duplicates). Of these, 1,776 were excluded based on the criteria set forth in the methods. The remaining unique 114 articles were included for qualitative synthesis.Discussion: We hope this article increases awareness and inspires action to address disparities and encourages research that further investigates previously identified disparities and explores not-yet-identified disparities.

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The impact of the affordable care act on breast cancer care in the USA: A multi‐institutional analysis

Cited by 2 publications

References 14 publications

Impact of Affordable Care Act provisions on the racial makeup of patients enrolled at a Deep South, high-risk breast cancer clinic

Impact of Affordable Care Act provisions on the racial makeup of patients enrolled at a Deep South, high-risk breast cancer clinic

Health Care Disparities in Radiology—A Review of the Current Literature

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