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Deductible for Breast Diagnostic Imaging May Discourage Follow-Up

21.1 percent of women were discouraged from returning for recommended follow-up imaging with deductible for diagnostic imaging

By Elana Gotkine HealthDay Reporter

WEDNESDAY, April 5, 2023 (HealthDay News) — Having a deductible for diagnostic imaging generated from abnormal breast screening examination may discourage more than one-fifth of women from returning for recommended diagnostic imaging, according to a study published online April 4 in Radiology.

Michael Ngo, M.D., from the Chobanian and Avedisian School of Medicine in Boston, and colleagues examined the percentage of people who would hypothetically skip diagnostic breast imaging if out-of-pocket (OOP) expenses existed. Data were included from 714 respondents to the statement, “If I knew I had to pay a deductible for additional imaging [to make sure my screening mammogram is normal], I would skip this additional imaging.”

The researchers found that 21.1, 59.4, and 19.5 percent of patients agreed they would skip imaging, disagreed, and were undecided, respectively, with responses varying by race or ethnicity, education level, annual household income, and insurance payer. Those identifying as Hispanic, with a high school education or less, with an annual household income of >$35,000, and with Medicaid or no insurance made up the highest percentages of patients who would skip additional imaging (33.0, 31.0, 27.0, and 31.5 percent, respectively). Overall, 18.2 percent of patients agreed that they would skip screening mammography if they knew they had to pay a deductible for follow-up, while 65.8 and 16.0 percent disagreed and were undecided, respectively.

“Given that our study sample largely consisted of patients already at risk for delay in breast care, the high percentage of respondents who may delay indicated breast imaging due to OOP costs highlights the concern that these payments only exacerbate existing gaps in breast cancer outcomes,” the authors write.

One author disclosed financial ties to the medical device industry; a second author disclosed ties to the publishing and medical technology industries.

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