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Rural Healthcare Provider Perception of the "Women's Health and Cancer Rights Act" (1998)
Kristen Hardy
Cristiane Ueno, MD
West Virginia University, Division of Plastic Surgery
2019-02-14
Presenter: Kristen Hardy
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. This project and abstract is the original work of the student.
Director Name: Aaron Mason, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction:
The Women's Health and Cancer Rights Act (WHCRA) ensures all insurance carriers cover post-mastectomy breast reconstruction, yet disparities in breast reconstruction remain. Though the reasons are multifactorial, lack of practitioner knowledge regarding insurance coverage and differences in provider understanding of breast reconstruction rights may play a role in worsening disparities. Our objectives were to determine whether there is a need to increase WHCRA education for providers in rural areas, like West Virginia, and to assess providers' understanding of WHCRA.
Methods:
We collected data from health care providers participating in the Annual West Virginia Breast Cancer Conference in 2015, 2016 and 2018 using pre- and post-conference questionnaires designed to measure participants' understanding of WHCRA. We calculated an "effectiveness score", which represents the amount of people who transitioned from an incorrect to a correct answer following WHCRA education.
Results:
In 2015, the effectiveness score was -13.5%, with 61.7% of practitioners answering correctly post-course. In 2016, this score increased to 25.0%, with 84.4% answering correctly post-course. Following a year without the lecture, the effectiveness score in 2018 was once again decreased to -13.0%, with 65.2% of practitioners answering correctly post-course.
Conclusions:
This shows that there is inaccurate perception of WHCRA amongst some West Virginia practitioners. The differences between 2016 and 2018 suggests that practitioner education needs to be a continuum. There are well reported disparities in rural areas regarding access to breast-reconstruction counseling and education, and this study illustrates that lack of provider knowledge on WHCRA may contribute to these disparities.
