Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Pharmaceutical Sciences


Pharmacy Administration

First Advisor

Rahul Khanna

Second Advisor

Jeffrey Hallam

Third Advisor

Yi Yang

Relational Format



Breast cancer is the second most comcancer and the second leading cause of cancer-related death among women. The current project examined some key issues important for effective breast cancer management in the Medicaid population. Medicaid is one the largest healthcare insurance systems in the US providing coverage to more than 60 million low-income individuals. As a part of this project, three studies were conducted. The first study determined the healthcare burden associated with breast cancer in the form of healthcare use (inpatient, outpatient, and emergency room [ER] visits) and costs associated with the condition in the Medicaid population. Significant healthcare burden was observed as the all-cause inpatient, outpatient, and ER visits and the total all-cause costs were found to be significantly higher among women with breast cancer as compared to women without breast cancer. The second study determined the impact of pre-existing mental illness on guideline-consistent breast cancer treatment and breast cancer-related healthcare use among Medicaid enrollees diagnosed with breast cancer. Negative association was observed between pre-existing mental illness and guideline-consistent breast cancer treatment and breast cancer-related outpatient visits indicating treatment disparities among women with breast cancer with pre-existing mental illnesses. The third study determined factors associated with repeat mammography screening in the Medicaid population. Recipient characteristics including age, race, number of outpatient visits during the study period, number of emergency room visits during the study period, use of hormone replacement therapy, and routine cervical cancer screening significantly impacted receipt of repeat mammography screening. The findings of this project could be useful to Medicaid program planners in designing strategies aimed at reducing disparities in breast cancer-related healthcare in the Medicaid population.


Emphasis: Pharmacy Administration


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