Variation in screening mammography and Papanicolaou smear by primary care physician specialty and gatekeeper plan (United States).

Objective: To assess whether the specialty of a patient's primary care physician or being part of a gatekeeper plan influence breast and cervical cancer screening.

Methods: Cross-sectional study of women in a national sample. For mammography, we studied women aged 40 and above, and for Papanicolaou (Pap) smear, women aged 18-65 years.

Does patient cost sharing matter? Its impact on recommended versus controversial cancer screening services.

Objectives: To examine whether there are differential impacts of patient cost sharing and health plan organizational characteristics on the use of a recommended cancer screening service (mammography) versus a controversial cancer screening service (prostate cancer screening [PCS]).

Study Design: Observational cohort using the 1996 Medical Expenditure Panel Survey.

Patients And Methods: A nationally representative sample of privately insured individuals was examined.

Moving beyond the typologies of managed care: the example of health plan predictors of screening mammography.

Objectives: To develop a framework of factors to characterize health plans, to identify how plan characteristics were measured in a national survey, and to apply our findings to an analysis of the predictors of screening mammography.

Data Source: The primary data were from the 1996 Medical Expenditure Panel Survey.

Study Design: Women ages 40+, with private insurance, and no history of breast cancer were included in the study (N = 2,909).

Are gatekeeper requirements associated with cancer screening utilization?

Objective: There is widespread debate over whether health plans should require enrollees to use "gatekeepers," which are primary care providers that coordinate care and control access to specialists. However, little is known about whether health plan gatekeeper requirements improve or reduce quality-of-care. Our objective was to examine whether gatekeeper requirements are associated with the utilization of cancer screening for breast, cervical, and prostate cancer.

Prevalence of Bartonella infection among human immunodeficiency virus-infected patients with fever.

Bartonella infection can be difficult to diagnose, especially when it manifests as bacteremia, which is usually accompanied by nonspecific symptoms, such as fever. Therefore, we hypothesized that Bartonella infection represents an underrecognized cause of febrile illness. To determine the prevalence of Bartonella infection among patients presenting with fever, we evaluated 382 patients in San Francisco.