دورية أكاديمية
أعرض في EDS

Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured.

التفاصيل البيبلوغرافية
العنوان: Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured.
المؤلفون: Primm KM; Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.; Department of Epidemiology and Biostatistics, The University of California San Francisco, San Francisco, California, USA., Zhao H; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Adjei NN; Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Sun CC; Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Haas A; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Meyer LA; Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Chang S; Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
المصدر: Cancer medicine [Cancer Med] 2024 Jul; Vol. 13 (13), pp. e7461.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons Ltd Country of Publication: United States NLM ID: 101595310 Publication Model: Print Cited Medium: Internet ISSN: 2045-7634 (Electronic) Linking ISSN: 20457634 NLM ISO Abbreviation: Cancer Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-
مواضيع طبية MeSH: Medicaid* , Medically Uninsured*/statistics & numerical data , Patient Protection and Affordable Care Act* , Neoplasms*/mortality , Neoplasms*/therapy , Neoplasms*/economics , Insurance Coverage*/statistics & numerical data, Humans ; United States ; Female ; Middle Aged ; Male ; Adult ; Health Services Accessibility/statistics & numerical data
مستخلص: Background: The Affordable Care Act expanded Medicaid coverage for people with low income in the United States. Expanded insurance coverage could promote more timely access to cancer treatment, which could improve overall survival (OS), yet the long-term effects of Medicaid expansion (ME) remain unknown. We evaluated whether ME was associated with improved timely treatment initiation (TTI) and 3-year OS among patients with breast, cervical, colon, and lung cancers who were affected by the policy.
Methods: Medicaid-insured or uninsured patients aged 40-64 with stage I-III breast, cervical, colon, or non-small cell lung cancer within the National Cancer Database (NCDB). A difference-in-differences (DID) approach was used to compare changes in TTI (within 60 days) and 3-year OS between patients in ME states versus nonexpansion (NE) states before (2010-2013) and after (2015-2018) ME. Adjusted DID estimates for TTI and 3-year OS were calculated using multivariable linear regression and Cox proportional hazards regression models, respectively.
Results: ME was associated with a relative increase in TTI within 60 days for breast (DID = 4.6; p < 0.001), cervical (DID = 5.0 p = 0.013), and colon (DID = 4.0, p = 0.008), but not lung cancer (p = 0.505). In Cox regression analysis, ME was associated with improved 3-year OS for breast (DID hazard ratio [HR] = 0.82, p = 0.009), cervical (DID-HR = 0.81, p = 0.048), and lung (DID-HR = 0.87, p = 0.003). Changes in 3-year OS for colon cancer were not statistically different between ME and NE states (DID-HR, 0.77; p = 0.075).
Conclusions: Findings suggest that expanded insurance coverage can improve treatment and survival outcomes among low income and uninsured patients with cancer. As the debate surrounding ME continues nationwide, our findings serve as valuable insights to inform the development of policies aimed at fostering accessible and affordable healthcare for all.
(© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)
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معلومات مُعتمدة: RP 170259 Cancer Prevention and Research Institute of Texas; T32CA101642 United States NH NIH HHS
فهرسة مساهمة: Keywords: breast cancer; colorectal cancer; epidemiology and prevention; medicaid expansion; non small cell lung cancer; survival
تواريخ الأحداث: Date Created: 20240706 Date Completed: 20240706 Latest Revision: 20240708
رمز التحديث: 20240708
مُعرف محوري في PubMed: PMC11226780
DOI: 10.1002/cam4.7461
PMID: 38970338
قاعدة البيانات: MEDLINE
الوصف
تدمد:2045-7634
DOI:10.1002/cam4.7461