Disparities in access to cancer surgery after Medicaid expansion
| Autor: | Jose Wilson Mesquita-Neto, Peter Cmorej, Francis I. Macedo, Steve Kim, Donald W. Weaver, Hassan Mouzaihem |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Population Pilot Projects Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Neoplasms Health insurance Humans Medicine In patient 030212 general & internal medicine Healthcare Disparities education education.field_of_study Poverty Medicaid business.industry Cancer General Medicine Middle Aged medicine.disease United States Disadvantaged 030220 oncology & carcinogenesis Female Surgery business Cancer surgery Demography |
| Zdroj: | The American Journal of Surgery. 219:181-184 |
| ISSN: | 0002-9610 |
| Popis: | The Affordable Care Act (ACA) expanded Medicaid eligibility to persons with income up to 138% of the federal poverty line. We investigated how Medicaid expansion (ME) impacted the access to cancer-specific surgical care in the US.We used a nationwide population-based database (SEER) to identify patients with the 8 most prevalent cancers between 2007 and 2015. Adjusted difference-in-differences (DiD) and multivariate regression were used for statistical analysis.A total of 1,008,074 patients were included. Patients post-ME were diagnosed at an earlier stage (pre-ME, 27.6%; post-ME, 31.1%; P 0.001), and lack of insurance coverage decreased from 5.5% to 2.6% (P 0.001). Lower-SES population had improved access to surgical care (attributable benefit +3.18%; P 0.001). ME was an independent predictor of access-to-surgery (OR, 1.45; P 0.001), whereas African-American and Hispanic race were negative predictive factors.After ME, the population without insurance coverage decreased. This was associated with earlier cancer diagnosis and improved access to surgery in patients from economically disadvantaged communities. |
| Databáze: | OpenAIRE |
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