Screening mammography rates by specialty of the usual care physician.
BACKGROUND
Although Medicare began paying for screening mammography in 1991, utilization among enrollees has been low.


METHODS
The relation between the specialty of the usual care physician and the proportion of women 65 years of age and older receiving mammography.


METHODS
100% Medicare Part B claims for 186,526 female enrollees residing in Maine, New Hampshire, and Vermont during 1993 and 1994.


RESULTS
Among women of the target screening age (65 to 69 years), 55.4%, received mammography during the 2-year period. The highest rates of mammography were observed in women whose usual care physician was a gynecologist (77.9%; 95% CI, 75.8 to 79.9), followed by those treated by an internist (67.1%; CI, 66.5 to 67.7), family practitioner (58.1%; CI, 57.4 to 58.9), general practitioner (47.4%; CI, 45.4 to 49.5), and other specialists (41.3%; CI, 40.1 to 42.5). The lowest rates were observed in women who had no physician visits during the 2-year period (9.5%; CI, 8.7 to 10.4). Although screening rates were lower in women aged 70 years and older, a similar pattern was observed.


CONCLUSIONS
The probability of a Medicare enrollee's receiving screening mammography is strongly influenced by the specialty of her usual care physician. Covering a preventive service does not guarantee its use.
Finison
K S
KS
Maine Health Information Center, Manchester, USA.
Wellins
C A
CA
Wennberg
D E
DE
Lucas
F L
FL
D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D014487:Centers for Medicare and Medicaid Services, U.S.; D005260:Female; D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D008281:Maine; D008327:Mammography / Q000706:statistics & numerical data*; D006278:Medicare; D008511:Medicine / Q000706:statistics & numerical data*; D009513:New Hampshire; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013038:Specialization; D014481:United States; D014707:Vermont