title: Financial barriers to mammography: who pays out-of-pocket?
abstract: OBJECTIVE
  This study investigates how out-of-pocket payments for mammograms vary according to the characteristics of women and the states where they reside.
  
  
  METHODS
  We conducted a cross-sectional analysis for women >or=40 years using data from the 2000 National Health Interview Survey (NHIS) Cancer Control Module linked with state characteristics. Descriptive tabulations and logistic regressions were used to examine characteristics associated with out-of-pocket payment for a woman's most recent mammogram for the subset of approximately 7000 women reporting a mammogram within the past 2 years.
  
  
  RESULTS
  In 2000, the majority of women who received a mammogram within the past 2 years paid no out-of-pocket costs: 68% among those aged 40-64 and 85% among those aged >or=66. Among women aged 40-64 with a recent mammogram, characteristics associated with paying out-of-pocket for the last mammogram were white, non-Hispanic race/ethnicity, being uninsured, having non-HMO private coverage, place of residence outside the Northeast, in a non-metropolitan county, and in a state with low HMO penetration.
  
  
  CONCLUSIONS
  Public insurance and HMO coverage have been especially effective in eliminating financial barriers to mammography, but women 40-64 years with public coverage still lag behind their privately insured counterparts in using mammography. Out-of-pocket costs remain a barrier to use for uninsured women. Older women, although less likely than younger women to pay out-of-pocket for mammograms, remain less likely to use mammography than younger women.
authors: Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
authors: Diane M
authors: DM
authors: Makuc
authors: Nancy
authors: N
authors: Breen
authors: Helen I
authors: HI
authors: Meissner
authors: Sally W
authors: SW
authors: Vernon
authors: Alan
authors: A
authors: Cohen
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal / Q000191:economics* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D005102:Health Expenditures / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data; D008327:Mammography / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011203:Poverty; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D016387:Women's Health / Q000191:economics*