The effect of health insurance coverage on the appropriate use of recommended clinical preventive services
Abstract
Introduction Lack of health insurance coverage has been shown to reduce use of some preventive services. However, even when care is free or fully covered by insurance, clinical preventive services are not used at recommended levels. This study investigates the impact of different levels of health insurance coverage (ranging from none, some, most, and all preventive services covered) on the use of recommended clinical preventive services for adult men and women. Methods Logistic regression was used to estimate the effect of different levels of health insurance coverage for preventive care on the probability of receiving six different clinical preventive services including periodic health exam, blood pressure screening, cholesterol screening, Pap smear, clinical breast exam, and screening mammography, as well as all recommended services for a given age and gender group. The study sample of adults ages 18 to 64 is from the Centers for Disease Control's 1991 Behavioral Risk Factor Surveillance System (BRFSS) (n = 53,981). Results The results demonstrate a positive and statistically significant dose-response relationship between level of health insurance coverage for preventive care and receipt of recommended preventive services in adult men and women. The odds ratios (ORs) of men who had full coverage for preventive care receiving recommended preventive services compared to men with no coverage for preventive care ranged from 1.8 to 2.8. For women the ORs were 1.2 to 2.0. The ORs…
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Other studies have shown disparity in utilization of U.S. Preventive Services Task Force-supported preventive care services such as blood pressure and cholesterol screening based on insurance status, though not necessarily based on income.
“Other studies have shown the disparity in utilization of preventive care services supported by the U.S. Preventive Services Task Force such as BP and cholesterol screening based on insurance status, though not necessarily based on income [27,28].”
From Income disparity and utilization of cardiovascular preventive care services among U.S. adults (2021) · cites this paper as [27]
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- Authors
- Faulkner, L. A., & Schauffler, H. H.
- Affiliations
- University of California, Berkeley (US)
- Corresponding author
- Schauffler, Helen Halpin
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 1997-11
- Volume
- 13
- Issue
- 6
- Pages
- 453-458
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W2646416
- Cited by
- 99
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 4 · 2014: 3 · 2013: 3 · 2012: 2
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- health insurance coverage, clinical preventive services, preventive care utilization, dose-response relationship, periodic health examination, blood pressure screening, cholesterol screening, Pap smear, clinical breast examination, mammography, adult men and women, Behavioral Risk Factor Surveillance System
- MeSH terms
- Adolescent, Adult, Cross-Sectional Studies, Female, Humans, Insurance, Health, Male, Middle Aged, Preventive Health Services, Sex Factors, United States, Logistic Models
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