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Explaining Variations in Breast Cancer Screening Across European Countries

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  • Ansgar Wübker

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Abstract

This paper explores variations in the uptake of breast cancer screening and associated factors influencing utilisation of mammography screening among women aged 50 to 69 years in 13 European countries. We focus on the relative importance of individual (e.g. age, education, etc.) and institutional (e.g. public screening program) factors in explaining cross-country variation in the utilisation of mammograms. We take advantage of (a) newly available individual level data from the SHARE as well as (b) regional and country level data on institutional factors. We find that observed individual factors like age, education, health status, etc. are associated with screening uptake within countries but cannot statistically explain cross-country differences. In contrast, observed institutional factors like the availability of an organized screening program can statistically explain about 40 per cent of the between country differences in screening rates.

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Bibliographic Info

Paper provided by Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen in its series Ruhr Economic Papers with number 0370.

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Length: 37 pages
Date of creation: Oct 2012
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Handle: RePEc:rwi:repape:0370

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Keywords: Health economics; prevention; multilevel models; SHARE; cross country differences;

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  1. Byrne, Margaret M. & Thompson, Peter, 2001. "Screening and preventable illness," Journal of Health Economics, Elsevier, vol. 20(6), pages 1077-1088, November.
  2. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr.
  3. Kristian Bolin & Anna Lindgren & Bjorn Lindgren & Petter Lundborg, 2008. "Utilisation of Physician Services in the 50+ Population. The Relative Importance of Individual versus Institutional Factors in 10 European Countries," NBER Working Papers 14096, National Bureau of Economic Research, Inc.
  4. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  5. Antonio Giuffrida & Hugh Gravelle, 1998. "Paying patients to comply: an economic analysis," Health Economics, John Wiley & Sons, Ltd., vol. 7(7), pages 569-579.
  6. Dardanoni, Valentino & Wagstaff, Adam, 1990. "Uncertainty and the demand for medical care," Journal of Health Economics, Elsevier, vol. 9(1), pages 23-38, June.
  7. Jinhu Li & Jeremiah Hurley & Philip DeCicca & Gioia Buckley, 2011. "Physician Response to Pay-for-Performance: Evidence from a Natural Experiment," NBER Working Papers 16909, National Bureau of Economic Research, Inc.
  8. Hendrik Schmitz & Ansgar Wübker, 2011. "What determines influenza vaccination take‐up of elderly Europeans?," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1281-1297, November.
  9. Lairson, David R. & Chan, Wenyaw & Newmark, Georgina R., 2005. "Determinants of the demand for breast cancer screening among women veterans in the United States," Social Science & Medicine, Elsevier, vol. 61(7), pages 1608-1617, October.
  10. Vincenzo Carrieri & Marcel Bilger, 2013. "Preventive care: underused even when free. Is there something else at work?," Applied Economics, Taylor & Francis Journals, vol. 45(2), pages 239-253, January.
  11. Chang, Fwu-Ranq, 1996. "Uncertainty and investment in health," Journal of Health Economics, Elsevier, vol. 15(3), pages 369-376, June.
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