Targeted mailed materials and the Medicare beneficiary: Increasing mammogram screening among the elderly

Objectives. Older women have the highest breast cancer rates but air under- screened relative to their risk. Racial/ethnic minority women especially ha ve low screening rates, often because of financial constraints. In response , Medicare introduced subsidized biennial mammogram benefits in 1991. This study examined the effect on mammography rates of an intervention that info rmed women about the Medicare bt nt fit. Methods. A list Frame method of subject selection was used to select random samples of eligible women from the Health Care Financing Administration's master beneficiary file. Women were interviewed by telephone in 1991 (N=917 ) before the targeted mailing and in 1993 (N=922). One control and 2 treatm ent communities participated. Results. Mammogram use increased significantly among minorities in the trea tment groups. Among minorities who received the intervention, Black women w ere twice as likely (odds ratio=1.97) and Hispanic women were more than twi ce as likely (odds ratio=2.33) to undergo screening relative to their untre ated cohorts. Conclusions. A targeted low-cost mailed intervention can help increase scre ening rates among elderly minority women. The Health Care Financing Adminis tration should promote its benefits aggressively if it expects to reach its target-elderly beneficiaries.