Financial incentive and the use of mammography among Hispanic migrants to the United States

Abstract

Researchers in migrant health clinics in Washington state found cost to be the single most commonly reported reason given by foreign-born Hispanic women for never having had a mammogram. The true significance of this finding beyond self-report was unknown. A randomized intervention trial designed to test the effect of fully subsidized mammograms on utilization was conducted within this population. Women in the intervention group received standard clinic instruction plus a voucher for a free mammogram. Controls received standard clinic instruction alone. Eighty-seven percent of women receiving vouchers obtained a mammogram within 30 days, compared with 17.5% of controls. Logistic regression analysis revealed that women receiving vouchers were 47 times more likely to obtain a mammogram than controls. This confirms women's self-report that cost is a major barrier to accessing screening mammograms in this low-income migrant population, and that women are more likely to utilize this service when financial barriers are removed.