دورية أكاديمية
أعرض في EDS

Impact of Health Insurance on Stage at Cancer Diagnosis Among Adolescents and Young Adults.

التفاصيل البيبلوغرافية
العنوان: Impact of Health Insurance on Stage at Cancer Diagnosis Among Adolescents and Young Adults.
المؤلفون: Keegan THM, Parsons HM, Chen Y, Maguire FB, Morris CR, Parikh-Patel A, Kizer KW, Wun T
المصدر: Journal of the National Cancer Institute [J Natl Cancer Inst] 2019 Nov 01; Vol. 111 (11), pp. 1152-1160.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: United States NLM ID: 7503089 Publication Model: Print Cited Medium: Internet ISSN: 1460-2105 (Electronic) Linking ISSN: 00278874 NLM ISO Abbreviation: J Natl Cancer Inst Subsets: MEDLINE
أسماء مطبوعة: Publication: <2003-> : Cary, NC : Oxford University Press
Original Publication: Bethesda, Md., U. S. Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health; Washington, for sale by the Supt. of Docs., U. S. Govt. Print. Off.
مواضيع طبية MeSH: Severity of Illness Index*, Ethnicity/*statistics & numerical data , Health Services Accessibility/*economics , Insurance Coverage/*statistics & numerical data , Insurance, Health/*statistics & numerical data , Medically Uninsured/*statistics & numerical data , Neoplasms/*diagnosis, Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/classification ; Neoplasms/pathology ; Socioeconomic Factors ; United States ; Young Adult
مستخلص: Background: Uninsured adolescents and young adults (AYAs) and those with publicly funded health insurance are more likely to be diagnosed with cancer at later stages. However, prior population-based studies have not distinguished between AYAs who were continuously uninsured from those who gained Medicaid coverage at the time of cancer diagnosis.
Methods: AYA patients (ages 15-39 years) with nine common cancers diagnosed from 2005 to 2014 were identified using California Cancer Registry data. This cohort was linked to California Medicaid enrollment files to determine continuous enrollment, discontinuous enrollment, or enrollment at diagnosis, with other types of insurance determined from registry data. Multivariable logistic regression was used to evaluate factors associated with later stages at diagnosis.
Results: The majority of 52 774 AYA cancer patients had private or military insurance (67.6%), followed by continuous Medicaid (12.4%), Medicaid at diagnosis (8.5%), discontinuous Medicaid (3.9%), other public insurance (1.6%), no insurance (2.9%), or unknown insurance (3.1%). Of the 13 069 with Medicaid insurance, 50.1% were continuously enrolled. Compared to those who were privately insured, AYAs who enrolled in Medicaid at diagnosis were 2.2-2.5 times more likely to be diagnosed with later stage disease, whereas AYAs discontinuously enrolled were 1.7-1.9 times and AYAs continuously enrolled were 1.4-1.5 times more likely to be diagnosed with later stage disease. Males, those residing in lower socioeconomic neighborhoods, and AYAs of Hispanic or black race and ethnicity (vs non-Hispanic white) were more likely to be diagnosed at a later stage, independent of insurance.
Conclusions: Our findings suggest that access to continuous medical insurance is important for decreasing the likelihood of late stage cancer diagnosis.
(© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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معلومات مُعتمدة: HHSN261201000140C United States CA NCI NIH HHS; HHSN261201000035C United States CA NCI NIH HHS; HHSN261201000034C United States CA NCI NIH HHS; U58 DP003862 United States DP NCCDPHP CDC HHS
تواريخ الأحداث: Date Created: 20190403 Date Completed: 20200615 Latest Revision: 20211204
رمز التحديث: 20240513
مُعرف محوري في PubMed: PMC6855930
DOI: 10.1093/jnci/djz039
PMID: 30937440
قاعدة البيانات: MEDLINE
الوصف
تدمد:1460-2105
DOI:10.1093/jnci/djz039