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N Breen

Publications and source records attributed to N Breen.

23 records · Page 2Linked to original sources
PubMed1994

The price of mammography in the United States: data from the National Survey of Mammography Facilities.

Data from the National Survey of Mammography Facilities are used to explore the efficiency of service delivery by mammography facilities. Screening mammography generally costs $100 or more. This study outlines principles recommended to lower unit costs of screening mammography and examines the extent to which facilities surveyed employed them. It reports charges, volume, and other facility characteristics, comparing them with the assumptions regarding these features in a study by the Physician Pricing Review Commission. That study, sponsored by the federal government, concluded that screening mammography can be delivered for around $60; however, only 14 percent of the facilities achieved the requisite volume of 15 or more mammograms per day. Facilities must become more efficient in order to charge the lower rates. This case study may have relevance for other potentially expensive preventive measures and medical procedures.

Data Collection↗
PubMedDate not supplied

Inner-city hospital closures in Dublin: implications for general practice.

BACKGROUND: The Meath, Adelaide and National Children's Hospitals provided more than 300,000 ambulatory care episodes in 1996, half to residents of the adjacent inner-city postal districts. With the closure of the group in 1998, alternative care arrangements must now be provided. AIMS: This paper examines the socio-economic and primary care characteristics of the communities most affected. METHODS: Data on the 13 District Electoral Divisions surrounding the hospitals are drawn from a range of published sources. RESULTS: The populations affected include 52% in social classes 5 to 7, have an average Standardised Mortality Ratio of 122, have high levels of GMS eligibility and include special care issues such as drug dependency. A total of 38 GPs cover the area. Other markers of deprivation are summarised. CONCLUSION: The areas most affected by the closures have existing high levels of deprivation and social and medical need. Initiatives to respond to the closures must address these needs.

Community Health Services↗
PubMedDate not supplied

Stage of breast and cervical cancer diagnosis in disadvantaged neighborhoods: a prevention policy perspective.

INTRODUCTION: Public health research on cancer and socioeconomic status (SES) has shown that higher SES is related to greater access to services. Using neighborhood-level measures of SES, we test hypotheses related to stage of breast and cervical cancer diagnosis. METHODS: SEER data on women diagnosed with breast or cervical cancer in 1989 and 1990 in San Francisco, Atlanta, and Detroit were matched with 1990 Census tract data. Cases were grouped as "in situ" or "invasive" at diagnosis. Using multivariate logistic regression in two separate models, we investigated whether residence in a poverty-tract or, alternatively, a disadvantaged neighborhood is associated with increased likelihood of diagnosis with invasive tumors. RESULTS: Living in a socioeconomically disadvantaged neighborhood was a strong, consistent predictor of invasive cancer. Living in a neighborhood with a high proportion of households in poverty was also a significant predictor for cervical cancer. CONCLUSIONS: Our results suggest specific neighborhoods that would benefit from clinical interventions. Lack of economic and social resources constrains individuals living in these neighborhoods from taking advantage of interventions targeting individual behavior. Thus, interventions in the small proportion of disadvantaged neighborhoods, we argue, need to target the entire community. Further, policy reform at the community level becomes more feasible when need can be specified for a particular census tract.

Adult↗
PubMedDate not supplied

The effect of Medicare reimbursement for screening mammography on utilization and payment. National Cancer Institute Breast Cancer Screening Consortium.

OBJECTIVE: In January 1991, Medicare extended its mammography benefit to reimburse for breast cancer screening mammograms. In 1991 and again in 1993, the National Cancer Institute Breast Cancer Screening Consortium (BCSC) conducted a survey to test the hypothesis that this benefit would increase mammography use among women over the age of 65. METHODS: The authors analyzed data on non-Hispanic white women ages 65 to 74 living in 11 geographic areas targeted by the BCSC for an earlier study--six that had received cancer screening educational interventions and five control subsites--to measure the impact of the newly adopted Medicare benefit on the use of mammography and use of Medicare to reimburse mammography costs. RESULTS: The data show little overall increase between 1991 and 1993 in reported mammography use among respondents to the survey. However, in six intervention and five control subsites there was an increase in the percentage of women who reported using public payment sources to at least partially reimburse the cost of mammograms. In three intervention subsites, the increase from 1991 to 1993 in the percentage of women using public sources of payment was greater than in the corresponding control subsites. CONCLUSIONS: These findings suggest that public health interventions are more likely to succeed when educational promotion accompanies a financial benefit.

Aged↗