Date of Thesis

5-7-2015

Thesis Type

Honors Thesis (Bucknell Access Only)

Degree Type

Bachelor of Science

First Advisor

Amy Wolaver

Abstract

Through adequate well-women visits, periodic pap smears, and thus the early detection of HPV, cervical cancer diagnoses are largely preventable(Bosch et al., 1995) This kind of preventable diagnosis is what is known as an Ambulatory Care Sensitive Condition, or ACSC. ACSC diagnoses are responsible for much of the overspending that occurs in the US's current healthcare system, and due to their preventable nature, serve as a red flag that large sections of the population are receiving inadequate primary care. Cervical cancer diagnoses, specifically, indicate inadequate reproductive healthcare among those women diagnosed. This study aims to better understand underlying patient and neighborhood characteristics that may contribute to this adverse health outcome, with a focus on the impact of insurance status. Applying health economic and econometric theory to the analysis of inpatient hospital data provided by the Pennsylvania Healthcare Cost Containment Council (PHC4) as well as Census data, we tested to see if certain patient characteristics, primarily insurance status but also race, and zip code characteristics including median household income, poverty rate, and educational attainment levels, help explain adverse cervical cancer outcomes. We also tested to see if clear disparities exist between specific sections of the population and if any policy implications can be made about the potential impacts of the ACA. The results showed that, for most outcomes tested, racial disparities were insignificant and that changes in insurance status did not help to narrow any gaps that were identified. We did find, however, that being privately insured yielded consistently better outcomes than being uninsured, while Medicaid insured patients had consistently worse outcomes than their privately insured counterparts. This result is difficult to interpret, however, as we could not control for a patient's individual socioeconomic status.

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