title: Differences in breast cancer diagnosis and treatment: experiences of insured and uninsured women in a safety-net setting.
abstract: To explore how well the safety net performs at eliminating differences in diagnosis and treatment of insured and uninsured women with breast cancer, we compared insured and uninsured women treated in a safety-net setting. Controlling for socioeconomic characteristics, uninsured women are more likely to be diagnosed with advanced disease, requiring more extensive treatment relative to insured women, and also experience delays in initiating and completing treatment. The findings suggest that, despite the safety-net system, uninsured women with breast cancer are likely to require more costly treatment and to have worse outcomes relative to insured women with breast cancer.
authors.affiliation: Department of Health Administration, Virginia Commonwealth University, Richmond, VA 23298, USA. cjbradley@vcu.edu
authors.forename: Cathy J
authors.initials: CJ
authors.lastname: Bradley
authors.forename: David
authors.initials: D
authors.lastname: Neumark
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Shickle
authors.forename: Nicholas
authors.initials: N
authors.lastname: Farrell
mesh_terms: D017677:Age Distribution; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012959:Socioeconomic Factors