February 2013

Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


This study describes the association between health insurance continuity and receipt of cervical cancer preventive services among female patients who accessed care in a network of Oregon and California safety net clinics between 2008 and 2010. Data were gleaned from electronic health records supplied by OCHIN Inc., a non-profit organization that provides networked electronic health records to community health centers across the United States. A series of bi-level log-binomial regression models were used to estimate adjusted prevalence ratios and 95% confidence intervals for receipt of cervical cancer preventive services by insurance continuity. Patient-level factors were modeled as fixed effects at level 1. The patient's home clinic was included as a random intercept at level 2. Three separate cervical cancer preventive service outcomes were examined, each in a distinct population: 1) Receipt of≥ 1 routine Pap test in 2008-2010 among established female patients ages 24-64 (n=11,560); 2




School of Medicine



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