TYPE OF HEALTH-CARE COVERAGE AND THE LIKELIHOOD OF BEING SCREENED FORCANCER

OBJECTIVES. This study explored whether type of outpatient health cove rage affected the likelihood of men and women aged 20 to 64 years rece iving recommended cancer screening procedures. METHODS. Data from the 1989 and 1990 California Behavioral Risk Factor Surveillance Surveys w ere used to compare Pap smear, mammogram, fecal occult blood test, and proctoscopic examination rates for adults with three different types of private health care coverage (Group/staff model health maintenance organization, Independent Practice Association Model health maintenanc e organization, indemnity plan) and no outpatient health insurance. Lo gistic regression models were used to control for sociodemographic and health characteristics and whether individuals had a usual health car e provider. RESULTS. Individuals with Group Model health maintenance o rganization coverage were significantly more likely than those with in demnity plans to have had recent cervical, breast, and colorectal canc er screening, whereas screening likelihood for those with Independent Practice Association model health maintenance organization coverage di d not differ substantially from those with indemnity plans. Individual s with no outpatient coverage were less likely to be screened than tho se with outpatient coverage. The most consistently significant predict or across cancer screening procedures for both men and women was havin g a usual doctor who knew their medical history. CONCLUSIONS. Adults w ho had private outpatient insurance were more likely to undergo recomm ended cancer detection procedures than those who did not. Adults who b elonged to a health maintenance organization, which emphasizes and pay s for a broader spectrum preventive care, were more likely to receive Pap smears, mammograms, and fecal occult blood tests than those covere d by indemnity plans. Receiving care primarily from one doctor signifi cantly increased the likelihood of having screening procedures, irresp ective of type of health plan.