Assessment of clinical outcome and health insurance coverage among patients with breast cancer
Breast cancer is a global health concern in terms of morbidity and mortality. Risksharing mechanisms such as health insurance provide resources and promote access to healthcare. The aim of the study was to assess the relationship between health insurance coverage and clinical outcome of breast cancer patients. The study employed retrospective design involving the use of secondary data from the patients diagnosed with breast cancer. Between the period of 2015 to 2019, 250 patients’ records were reviewed from a sample size of 300 patients over 5 year patients’ follow-up period. A descriptive and Kaplan Meier survival analysis was performed to determine the patients’ survival rate. Seventy-two percent of the patients had health insurance cover at the time of diagnosis. Insurance status was found to be significantly associated with survival (p-values= 0.036). Insurance cover had 1.42 hazard ratio (p=0.036, 95% CI: 1.023-1.980). Patients with health insurance coverage at the time of diagnosis had a higher survival rate. No significant association was found among the demographic characteristics and the patients’ clinical outcomes.
Benson JR, Jatoi I. The global breast cancer burden. Future oncology. 2012 Jun;8(6):697-702.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C. GLOBOCAN 2012 v1. 0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. International Agency for Research on Cancer.
Obrist, M., Osei-Bonsu E, Awuah B, Watanabe-Galloway S, Merajver SD, Schmid K, Soliman AS. Factors related to the incomplete treatment of breast cancer in Kumasi, Ghana. The Breast. 2014, 1;23(6):821-8.
Suh MA, Atashili J, Fuh EA, Eta VA. Breast self-examination and breast cancer awareness in women in developing countries: a survey of women in Buea, Cameroon. BMC Research Notes. 2012;5(1):627.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018 Nov;68(6):394-424.
Leach MJ, Wiese M, Thakkar M, Agnew T. Integrative health care-Toward a common understanding: A mixed method study. Complementary Therapies in Clinical Practice. 2018, 28;30:50-7.
Hadley J. Sicker and poorer—The consequences of being uninsured: A review of the research on the relationship between health insurance, medical care use, health, work, and income. Medical Care Research and Review. 2003;60(2_suppl):3S-75S.
National Healthcare Quality Report. Chapter 10: Access to Healthcare. Rockville (MD): Agency for Healthcare Research and Quality, 2013. Available from: http://www.ahrq.gov/research/findings/nhqrdr/nhqdr15/access.html. Accessed on January 14, 2019.
WHO-EM. years of vital health care, Fact Sheet, Geneva: WHO, 2007, No. 325.
Peto R, Boreham J, Clarke M, Davies C, Beral V. UK, and USA breast cancer deaths down 25% in the year 2000 at ages 20–69 years. The Lancet. 2000, 20;355(9217):1822.
Agbokey FR. Health Seeking Behaviours for Breast Cancer among Breast Cancer Patients at the Komfo Anokye Teaching Hospital, Kumasi, Ghana (Doctoral dissertation, University of Ghana).
Opoku SY, Benwell M. Knowledge, attitudes, beliefs, behavior and breast cancer screening practices in Ghana. European Journal of Cancer. 2018, 1;92: S89.
Ayanian JZ, Kohler BA, Abe T, Epstein AM. The relation between health insurance coverage and clinical outcomes among women with breast cancer. New England Journal of Medicine. 1993, 29;329(5):326-31.
Ward EM, Fedewa SA, Cokkinides V, Virgo K. The association of insurance and stage at diagnosis among patients aged 55 to 74 years in the national cancer database. The Cancer Journal. 2010, 1;16(6):614-21.
Debrah, A. (2015). Anas Aremeyaw Anas & Chika Oduah explore why breast cancer is more likely to kill African women. Africa Watch, Retrieved from
Stark A, Kleer CG, Martin I, Awuah B, Nsiah‐Asare A, Takyi V, Braman M, E. Quayson S, Zarbo R, Wicha M, Newman L. African ancestry and higher prevalence of triple‐negative breast cancer: findings from an international study. Cancer. 2010, 1;116(21): 4926-32.
Kyei KA, Opoku SY, Antwi WK, Engel-Hills P. The Radiation Therapist in Pain Assessment.
Mensah AC, Yarney J, Nokoe SK, Opoku S, Clegg-Lamptey JN. Survival outcomes of breast cancer in Ghana: an analysis of clinicopathological features. Open Access Library J. 2016, 29;3:1-1.
Bowen RL, Stebbing J, Jones LJ. A review of the ethnic differences in breast cancer. Pharmacogenomics. 2006; 7:935–942.
Haas JS, Kaplan CP, Brawarsky P, Kerlikowske K. Evaluation and outcomes of women with a breast lump and a normal mammogram result. Journal of General Internal Medicine. 2005, 1;20(8):692
Hahn KM, Bondy ML, Selvan M, Lund MJ, Liff JM, Flagg EW, Brinton LA, Porter P, Eley JW, Coates RJ. Factors associated with advanced disease stage at diagnosis in a population-based study of patients with newly diagnosed breast cancer. American Journal of Epidemiology. 2007, 9;166(9):1035-44.
Halpern MT, Bian J, Ward EM, Schrag NM, Chen AY. Insurance status and stage of cancer at diagnosis among women with breast cancer. Cancer. 2007, 15;110(2):403-11.
Wheeler SB, Reeder-Hayes KE, Carey LA. Disparities in breast cancer treatment and outcomes: biological, social, and health system determinants and opportunities for research. The Oncologist. 2013, 1;18(9):986-93.
Kyei KA, Oswald JW, Njoku AU, Kyei JB, Vanderpuye V, Tschida P. Anxiety and Depression among Breast Cancer Patients undergoing treatment in Ghana: Anxiety and Depression. African Journal of Biomedical Research. 2020 Apr 21;23(2):227-32.
Sanuade OA, Ayettey H, Hewlett S, Dedey F, Wu L, Akingbola T, Ogedegbe G, de-Graft Aikins A. Understanding the causes of breast cancer treatment delays at a teaching hospital in Ghana. Journal of Health Psychology. 2018 Nov 30:1359105318814152.
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