PHS155 - Moral hazard and health insurance: examining the role of private vs. Public insurance in prostate cancer screening, prostate cancer diagonosis and patient satisfaction with prostate cancer care

Abstract

The objectives of the study were to compare the likelihood of prostate-specific antigen (PSA) screening, the likelihood of prostate cancer diagnosis (in those who were PSA screened), and patient satisfaction (in those who received a prostate cancer diagnosis) in men covered by private vs. public insurance. This was a retrospective cross-sectional study of U.S. men 40 to 85 years of age. A nationally representative Medical Expenditure Panel Survey (MEPS) data on American households was utilized to identify all men by age and by insurance status for years 2002 to 2011. Overall, 15202 men covered by any private insurance and 7409 men covered by any public insurance reported PSA screening within the last two years. Of these men, 751 covered by private insurance vs. 402 covered by public insurance received a diagnosis of prostate believed cancer within the last two years. In 2011, 102 men covered by private insurance vs. 59 men covered by public insurance reported a diagnosis of prostate cancer. In 2011, 77 men (or 75%) covered by private insurance vs. 28 men (or 47%) covered by public insurance reported they were covered by health insurance that paid for all part of the medical care, tests or cancer treatment, p=0.058. Forty-seven men or (46%) covered by private insurance vs. 15 men (or 25%) covered by public insurance reported cancer will come back to them or get worse within the next ten years. More men were likely to get PSA screened and diagnosed with prostate cancer if covered by private insurance. More men covered by private insurance believed their insurance covered all the necessary prostate cancer care. However, more men covered by private insurance feared a relapse. The role of health insurance in cancer care trajectory and patient satisfaction with care needs further exploration.