ArticleHealth affairs (Project Hope)2019
Vulnerable And Less Vulnerable Women In High-Deductible Health Plans Experienced Delayed Breast Cancer Care.
Article in Health affairs (Project Hope), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cost-sharing and adherence, clinical outcomes, health care utilization, and costs: A systematic literature review.Journal of managed care & specialty pharmacy · 2023Pooled it
- Impact of High Deductible Health Plans on Diabetes Care Quality and Outcomes: Systematic Review.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2021Pooled it
- Out-of-Pocket Costs for Chronic Illness Management in High-Deductible Health Plans.JAMA network open · 2026Article
- Opioid Use Disorder Care Presentations After High-deductible Health Plan Enrollment.Journal of addiction medicine · 2026Article
- Medical debt, financial risk factors, and deferred care among low-wage workers.Health affairs scholar · 2025Article
- Estimated Out-of-Pocket Costs for Patients With Common Cancers and Private Insurance.JAMA network open · 2025Article
- Disparities in time to treatment initiation of invasive lung cancer among Black and White patients in Tennessee.PloS one · 2025Article
- Financial Distress in Testicular Cancer Survivors and Its Impact on Cancer Survivors' Quality of Life in the German Healthcare System.Urologia internationalis · 2025Article
- Enrollment in High-deductible Health Plans Among People Younger Than Age 65 With Private Health Insurance: United States, 2019-2023.National health statistics reports · 2024Article
- Economic Evidence on Cost Sharing and Alternative Insurance Designs to Address Moral and Behavioral Hazards in High-Income Health Care Systems: A Systematic Review.Journal of market access & health policy · 2024Review
- Deductible imputation in administrative medical claims datasets.Health services research · 2024Article
- Decision for Carpal Tunnel Surgery: High-deductible Health Plans versus Traditional Health Plans.Plastic and reconstructive surgery. Global open · 2024Article
- Examining Medicaid Waivers-An Opportunity to Promote Equity in Cancer Care.JAMA oncology · 2024Article
- Catastrophic health expenditures, insurance churn, and non-employment among women with breast cancer.JNCI cancer spectrum · 2024Article
- Association of High-Deductible Health Plans and Time to Surgery for Breast and Colon Cancer.Journal of the American College of Surgeons · 2023Article
- Are Diagnostic Delays Associated with Distress in Breast Cancer Patients?Breast care (Basel, Switzerland) · 2023Article
- Utilization and Spending With Preventive Drug Lists for Asthma Medications in High-Deductible Health Plans.JAMA network open · 2023Article
- Patient Cost-Sharing and Utilization of Breast Cancer Diagnostic Imaging by Patients Undergoing Subsequent Testing After a Screening Mammogram.JAMA network open · 2023Article
- Impact of High-Deductible Health Plans on Breast Reconstruction: Considerations for Financial Toxicity.Plastic and reconstructive surgery · 2023Article
- Disparities in timely treatment among young women with breast cancer.American journal of surgery · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
The effects of high-deductible health plans (HDHPs) on breast cancer diagnosis and treatment among vulnerable populations are unknown. We examined time to first breast cancer diagnostic testing, diagnosis, and chemotherapy among a group of women whose employers switched their insurance coverage from health plans with low deductibles ($500 or less) to plans with high deductibles ($1,000 or more) between 2004 and 2014. Primary subgroups of interest comprised 54,403 low-income and 76,776 high-income women continuously enrolled in low-deductible plans for a year and then up to four years in HDHPs. Matched controls had contemporaneous low-deductible enrollment. Low-income women in HDHPs experienced relative delays of 1.6 months to first breast imaging, 2.7 months to first biopsy, 6.6 months to incident early-stage breast cancer diagnosis, and 8.7 months to first chemotherapy. High-income HDHP members had shorter delays that did not differ significantly from those of their low-income counterparts. HDHP members living in metropolitan, nonmetropolitan, predominantly white, and predominantly nonwhite areas also experienced delayed breast cancer care. Policies may be needed to reduce out-of-pocket spending obligations for breast cancer care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.