Uninsured utilization of the mobile mammography: 10-year analysis.

Abstract

12 Background: Mobile Mammography Units (MMU) historically increase access breast cancer screening to uninsured patients. Our group previously reported insurance status predicts MMU repeat utilization (insured cohort most likely to repeat.) The purpose of this study is to examine the uninsured subset in multivariable analysis to understand the low repeat utilization by this group. Methods: From Jan 2001 to Dec 2010, 48,324 screening mammograms were performed in the largest county in KY. Of 21,587 unique subjects, 9,422 were uninsured (44%.) Demographic data was retrospectively reviewed to identify age, race/ethnicity, insurance status and location for each encounter. Utilization was defined as once or more than two times in a 10-year period. P-values were calculated using Chi-square test for comparison between the two groups. Odds ratio and its 95% confidence interval were provided. Logistics regression analysis is used to jointly model the effect of independent factors on repeat unitization of MMU. Results were declared significant at significance level of 5%. Results: Race, location, and age remain independent variables in likelihood of repeat utilization within a 10-year period (p value < .001.) The estimated OR are depicted in the table. We previously reported in the entire dataset (all insurance cohorts) and estimated OR of Whites (W) vs Blacks (B) of 0.897 (CI 0.843-0.955) and Hispanics (H) vs B 0.701 (CI 0.604-0.813.) Conclusions: Within the uninsured cohort, race and location remain independent predictors of repeat utilization of the MMU. However, the significance is weaker between W and B (p < .004 versus < .001) in the uninsured group than in the entire dataset which may suggest that insurance type becomes a stronger predictor of repeat utilization than race although further analysis will be necessary to confirm this trend.[Table: see text]