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Screening For Cancer And Market Structure:A Multilevel Analysis For Mammogram And Pap-Smear Utilization In The U.S


  • Yavuz Yasar

    (University of Denver)


This paper investigates the relationship between health care market structure and utilization of preventive care services, namely mammogram and Papanicolaou (Pap-smear) screening. In addition to their life saving aspects, it is always believed that preventive health care services are important due to their cost-effectiveness which would prevail under managed competition. Yet, the nature of managed competition has been changing as a result of the backlash against it since the mid-1990s. We have yet to provide a clear answer to the question of how market structure affects the utilization of preventive care in general, and how the latest changes in health care market have been affecting it. These are the primary research questions of the paper. These research questions are answered by employing a new methodology that has not been used before. A multilevel modeling technique is employed to study the impact of changes in the structure of health care market on the utilization of mammogram and Pap-smear tests. In addition, an unusual data source, insurance claims data, rather than surveys or discharge data, is used in this study.

Suggested Citation

  • Yavuz Yasar, 2005. "Screening For Cancer And Market Structure:A Multilevel Analysis For Mammogram And Pap-Smear Utilization In The U.S," HEW 0503002, University Library of Munich, Germany.
  • Handle: RePEc:wpa:wuwphe:0503002
    Note: Type of Document - pdf; pages: 45

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    References listed on IDEAS

    1. Debra Draper & Robert E. Hurley & Cara Lesser & Bradley C. Strunk, "undated". "The Changing Face of Managed Care," Mathematica Policy Research Reports 9fdbb8db440a4577b75689504, Mathematica Policy Research.
    2. Laurence C. Baker & Martin L. Brown, 1999. "Managed Care, Consolidation Among Health Care Providers, and Health Care: Evidence from Mammography," RAND Journal of Economics, The RAND Corporation, vol. 30(2), pages 351-374, Summer.
    3. Kenkel, D., 1988. "The Demand For Preventive Medical Care," Papers 3-88-4, Pennsylvania State - Department of Economics.
    4. 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 223-255, March-Apr.
    5. Robert E. Hurley & Bradley C. Strunk & Justin S. White, "undated". "The Puzzling Popularity of the PPO," Mathematica Policy Research Reports 1074a434a3ec420987bd2a4aa, Mathematica Policy Research.
    6. Harris Schlesinger & Emilio Venezian, 1986. "Insurance Markets with Loss-Prevention Activity: Profits, Market Structure, and Consumer Welfare," RAND Journal of Economics, The RAND Corporation, vol. 17(2), pages 227-238, Summer.
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    More about this item


    Mammogram; Pap-Smear; Utilization; Health Care Market; Multilevel Analysis.;

    JEL classification:

    • I - Health, Education, and Welfare

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