Abstract
Background/Aims The U.S. mammography screening rate is higher than rates of other preventive services among women, perhaps because efforts to encourage regular mammography have been relatively more effective than efforts to encourage other types of preventive care. The purposes of this study were to investigate the rate at which female members of Scott & White Health Plan received mammography without a primary care physician visit, and to identify any short-term health consequences of receiving mammography without other primary care services.
Methods This was a retrospective cohort study of female Scott & White Health Plan members between 2006 and 2009. We analyzed biennial mammography screening among women aged 40 through 69, following the Healthcare Effectiveness Data and Information Set (HEDIS) definition of screening mammography adherence. We considered primary care physician visits (PCP) as well as specialty provider visits during 12 month before and after the date of mammography in 2008. For the purpose of our analysis we divided the population into four groups: those who had any visit 12 months before the mammography screening date; those had any visit 12 months after that date; those had visits in both before and after the date; and finally those had visits in neither year. Our sample included 15,105 women who had mammography in 2008.
Results About 24% of women underwent mammography in 2008 without a PCP or specialty visit 12 months before or after the mammogram date. Members with no PCP or specialty visit 12 months before or after mammography had significantly lower rates of other periodic preventive screenings such as screenings for high cholesterol, diabetes, cervical cancer, and colon cancer. We found no significant impact on length of inpatient stays or emergency room visits for those who had no physician visit within 12 months of mammography.
Conclusions Mammography without PCP or specialty visits may adversely affect short-term preventive care utilization and long-term health outcomes. Because mammography screening was among the only contacts some women had with the healthcare system, it may be appropriate to introduce interventions for other types of preventive care when women present for screening mammography.
