Survival outcomes for head and neck patients with Medicaid: A health insurance paradox

Autor: Jaibir S Pannu, Nosayaba Osazuwa-Peters, Sai D Challapalli, Lauren M. Cass, Matthew C. Simpson, Sean T. Massa, Eric Adjei Boakye, Rebecca L. Rohde
Rok vydání: 2021
Předmět:
Zdroj: Head & Neck. 43:2136-2147
ISSN: 1097-0347
1043-3074
2007-2015
DOI: 10.1002/hed.26682
Popis: Purpose Privately insured patients with head and neck cancer (HNC) typically have better outcomes; however, differential outcome among Medicaid versus the uninsured is unclear. We aimed to describe outcome disparities among HNC patients uninsured versus on Medicaid. Methods A cohort of 18-64-year-old adults (n = 57 920) with index HNC from the Surveillance, Epidemiology, and End Results 18 database (2007-2015) was analyzed using Fine and Gray multivariable competing risks proportional hazards models for HNC-specific mortality. Results Medicaid (sdHR = 1.65, 95% CI 1.58, 1.72) and uninsured patients (sdHR = 1.55, 95% CI 1.46, 1.65) had significantly greater mortality hazard than non-Medicaid patients. Medicaid patients had increased HNC mortality hazard than those uninsured. Conclusion Compared with those uninsured, HNC patients on Medicaid did not have superior survival, suggesting that there may be underlying mechanisms/factors inherent in this patient population that could undermine access to care benefits from being on Medicaid.
Databáze: OpenAIRE
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