Compared with controls, the hazard ratios (HR) for each parameter were as follows:
Time to first diagnostic breast imaging: HR = 0.96 (95% confidence interval 0.94-0.96)
Time to first breast biopsy: HR = 0.92 (0.89-0.95)
Time to early stage breast cancer diagnosis: HR = 0.83 (0.78-0.90)
Time to breast cancer chemotherapy: HR = 0.79 (0.72-0.86)
“The findings imply that the high out-of-pocket obligations under HDHPs [high-deductible health plans] might be a barrier to timely receipt of essential breast cancer services. Women in HDHPs might either delay presenting for concerning symptoms or, if proceeding along the pathway from breast cancer screening to diagnostic testing to treatment, be hesitant to undergo subsequent (and generally more expensive) care,” the authors wrote.
They noted that initially modest delays in diagnostic imaging appeared to snowball into longer delays as women proceeded through stages of care.
They recommend a strategy whereby insurers carve out exemptions to high deductibles for services such as diagnostic imaging and breast biopsy.
SOURCE: Wharam et al. J Clin Oncol. 2018 Feb 28. doi: 10.1200/JCO.2017.75.2501.