title: Mammography usage with relevant factors among women with mental disabilities in Taiwan: a nationwide population-based study.
abstract: Women with mental illness are at increased risk of developing and dying from breast cancer and are thus in urgent need of breast cancer preventive care. This study examined the use of screening mammography by Taiwanese women with mental disabilities and analyzed factors affecting this use. 17,243 Taiwanese women with mental disabilities aged 50-69 years were retrospectively included as study subjects. Linked patient data were obtained from three national databases in Taiwan (the 2008 database of physically and mentally disabled persons, the Health Promotion Administration's 2007-2008 mammography screening data, and claims data from the National Health Insurance Research Database). Besides descriptive statistics and bivariate analysis, logistic regression analysis was also performed to examine factors affecting screening mammography use. The 2007-2008 mammography screening rate for Taiwanese women with mental disabilities was 8.79% (n=1515). Variables that significantly influenced screening use were income, education, presence of catastrophic illness/injury, severity of mental disability, and usage of other preventive care services. Screening was positively correlated with income and education. Those with catastrophic illness/injury were more likely to be screened (odds ratio [OR], 1.40; 95% CI=1.15-1.72). Severity of disability was negatively correlated with screening, with very severe, severe, and moderate disability being associated with 0.34-0.69 times the odds of screening as mild disability. In Taiwan, women with mental disabilities receive far less mammography screening than women in general.
authors.affiliation: Department of Public Health, China Medical University, Taichung, Taiwan, ROC; Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC; Department of Chinese Medicine, Nantou Hospital, Nantou, Taiwan, ROC. Electronic address: suhmayyen@yahoo.com.tw.
authors.forename: Suh-May
authors.initials: SM
authors.lastname: Yen
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC. Electronic address: ptkung@asia.edu.tw.
authors.forename: Pei-Tseng
authors.initials: PT
authors.lastname: Kung
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC. Electronic address: wtsai@mail.cmu.edu.tw.
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D016022:Case-Control Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D001523:Mental Disorders; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013624:Taiwan
keywords: Access and utilization; Mammography screening; Mental disability; Preventive care