Breast cancer treatment experiences by race and location in Georgia's women's health medicaid program

Emily M. Johnston, Sarah C. Blake, Karen L. Andes, Li Nien Chien, E. Kathleen Adams

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: This study seeks to understand the breast cancer treatment patterns and experiences of women enrolled in Georgia's Breast and Cervical Cancer Prevention and Treatment Act program, the Women's Health Medicaid Program (WHMP), and whether these experiences vary by race or location. Methods: We conducted a mixed-methods analysis of WHMP breast cancer enrollees by race and urban/rural location. Quantitative analysis used a hazard rate model approach to identify differences in the timing of diagnosis, enrollment into Medicaid, and various modalities of treatment for 810 enrollees. Qualitative analysis used a systematic retrieval and review of coded data from 34 in-depth disease life history interview transcripts to a complete, focused analysis of enrollees' cancer treatment experiences. Findings: African-American women began treatment, on average, 6 days later after diagnosis than White women, driven by delays of one month among African-American women with late-stage cancers. This time delay for African-American women was not significant on multivariate analysis of time from enrollment to treatment. Once enrolled in WHMP, women reported gaining access to equitable breast cancer treatment regardless of race or location, with the exception of breast reconstruction, for which some women in our sample reported barriers to care. Conclusions: The equitable access to cancer treatment and other health services provided by WHMP to low-income, uninsured women in Georgia with breast cancer makes it a critical health care safety net program in Georgia, the need for which will continue through the implementation of the Affordable Care Act.

Original languageEnglish
JournalWomen's Health Issues
Volume24
Issue number2
DOIs
Publication statusPublished - 2014

Fingerprint

Medicaid
Women's Health
cancer
Breast Neoplasms
health
experience
Women's Health Services
African Americans
Therapeutics
Patient Protection and Affordable Care Act
Neoplasms
Mammaplasty
Delayed Diagnosis
Critical Care
act
Proportional Hazards Models
Uterine Cervical Neoplasms
Multivariate Analysis
Interviews
Delivery of Health Care

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Public Health, Environmental and Occupational Health
  • Maternity and Midwifery
  • Health(social science)

Cite this

Breast cancer treatment experiences by race and location in Georgia's women's health medicaid program. / Johnston, Emily M.; Blake, Sarah C.; Andes, Karen L.; Chien, Li Nien; Adams, E. Kathleen.

In: Women's Health Issues, Vol. 24, No. 2, 2014.

Research output: Contribution to journalArticle

Johnston, Emily M. ; Blake, Sarah C. ; Andes, Karen L. ; Chien, Li Nien ; Adams, E. Kathleen. / Breast cancer treatment experiences by race and location in Georgia's women's health medicaid program. In: Women's Health Issues. 2014 ; Vol. 24, No. 2.
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