Insurance status and time to radiation care after pathologic diagnosis for cervical cancer patients.

Autor:	Saris DH; Pennsylvania Hospital, University of Pennsylvania Health System, Department of Obstetrics and Gynecology, Philadelphia, PA, United States., Pena D; Cornell University, Ithaca, NY, United States., Haggerty AF; Hackensack Meridian Health Group, Red Bank, NJ, United States., Taunk NK; University of Pennsylvania Health System, Division of Gynecologic Oncology, Philadelphia, PA, United States., Ko EM; University of Pennsylvania Health System, Division of Gynecologic Oncology, Philadelphia, PA, United States.; University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA, United States.; University of Pennsylvania, Leonard Davis Institute of Health Economics, University of Pennsylvania Health System, Philadelphia, PA, United States., Smith AJB; University of Pennsylvania Health System, Division of Gynecologic Oncology, Philadelphia, PA, United States.; University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA, United States.; University of Pennsylvania, Leonard Davis Institute of Health Economics, University of Pennsylvania Health System, Philadelphia, PA, United States.; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, PA, United States.
Jazyk:	angličtina
Zdroj:	Gynecologic oncology reports [Gynecol Oncol Rep] 2023 Apr 03; Vol. 47, pp. 101177. Date of Electronic Publication: 2023 Apr 03 (Print Publication: 2023).
DOI:	10.1016/j.gore.2023.101177
Abstrakt:	Delays in starting potentially curative treatment for locally-advanced cervical cancer (LACC) decrease survival. Reasons for these delays are poorly understood. We conducted a retrospective chart review examining disparities in time from diagnosis of LACC to first clinic visit and to initiation of treatment based on insurance status within a single health system. We analyzed time to treatment using multivariate regression, adjusted for race, age, and insurance status. 25% of patients had Medicaid and 53% had private insurance. Having Medicaid was associated with delayed time from diagnosis to seeing a radiation oncologist (Mean 76.9 v. 31.3 days, p = 0.03). However, time from first radiation oncology visit to starting radiation was not delayed (Mean 22.6 v. 22.2 days, p = 0.67). Patients with locally-advanced cervical cancer and Medicaid had over double the time from pathologic diagnosis of cervical cancer to seeing radiation oncology; insurance disparities were not observed in treatment start after seeing radiation oncology. Improved referral and navigation processes for patients with Medicaid are needed to improve timely receipt of radiation and potentially improve survival. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 Published by Elsevier Inc.)
Databáze:	MEDLINE
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