title: Sociodemographic differences in use of preventive services by women enrolled in Medicare+Choice plans.
abstract: BACKGROUND
  We examined the effect of sociodemographic factors on the receipt of mammography, colorectal cancer screening, and influenza vaccinations by women enrolled in two Medicare+Choice health plans.
  
  
  METHODS
  Administrative and survey data for 2,698 female health plan members was analyzed using multivariate logistic and ordinal logistic regression to assess the effects of enrollee characteristics on use of preventive services.
  
  
  RESULTS
  Age, race and wealth were associated with the receipt of one or more preventive services. Older women were less likely to receive mammograms, wealthier women were more likely to receive mammograms and CRC screening, and Black women were more likely to receive CRC screening but less likely to receive influenza vaccinations. Wealthier women received a greater number of preventive services, other things equal, while older women received fewer preventive services.
  
  
  CONCLUSIONS
  Race and wealth continue to be important factors in the receipt of preventive services by elderly women, though not always consistent with historical trends. Medicare+Choice plans should consider strategies to further reduce racial and wealth disparities in the use of preventive services.
authors.affiliation: RAND Health, Santa Monica, CA 90407, USA. morales@rand.org
authors.forename: Leo S
authors.initials: LS
authors.lastname: Morales
authors.forename: Jeannette
authors.initials: J
authors.lastname: Rogowski
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Freedman
authors.forename: Steven L
authors.initials: SL
authors.lastname: Wickstrom
authors.forename: John L
authors.initials: JL
authors.lastname: Adams
authors.forename: José J
authors.initials: JJ
authors.lastname: Escarce
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000175:diagnosis; D003710:Demography; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage; D006278:Medicare / Q000706:statistics & numerical data; D020398:Medicare Part C / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012959:Socioeconomic Factors
chemical_list: D007252:Influenza Vaccines