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Association of Medicare eligibility with access to and affordability of care among older cancer survivors.
Kwon, Youngmin; Roberts, Eric T; Degenholtz, Howard B; Jacobs, Bruce L; Sabik, Lindsay M.
Afiliação
  • Kwon Y; Department of Health Policy and Management, University of Pittsburgh, School of Public Health, A610 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA. yok84@pitt.edu.
  • Roberts ET; Department of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
  • Degenholtz HB; Department of Health Policy and Management, University of Pittsburgh, School of Public Health, A610 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
  • Jacobs BL; Department of Urology, Division of Health Services Research, University of Pittsburgh, School of Medicine, 3471 Fifth Ave, Suite 801, Pittsburgh, PA, 15213, USA.
  • Sabik LM; Department of Health Policy and Management, University of Pittsburgh, School of Public Health, A610 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
J Cancer Surviv ; 2024 Mar 23.
Article em En | MEDLINE | ID: mdl-38520599
ABSTRACT

PURPOSE:

Older cancer survivors have substantial needs for ongoing care, but they may encounter difficulties accessing care due to cost concerns. We examined whether near-universal insurance coverage through Medicare-a key source of health insurance coverage in this population-is associated with improvements in care access and affordability among older cancer survivors around age 65.

METHODS:

In a nationally representative sample of cancer survivors (aged 50-80) from 2006-2018 National Health Interview Survey, we employed a quasi-experimental, regression discontinuity design to estimate changes in insurance coverage, delayed/skipped care due to cost, and worries about or problems paying medical bills at age 65.

RESULTS:

Medicare coverage sharply increased from 8.3% at age 64 to 98.2% at age 65, ensuring near-universal insurance coverage (99.5%). Medicare eligibility at age 65 was associated with reductions in delayed/skipped care due to cost (discontinuity, - 5.7 percentage points or pp; 95% CI, - 8.1, - 3.3; P < .001), worries about paying for medical bills (- 7.7 pp; 95% CI, - 12.0, - 3.2; P = .001), and problems paying medical bills (- 3.2 pp; 95% CI, - 6.1, - 0.2; P = .036). However, a sizable proportion reported any access or affordability problems (29.7%) between ages 66 and 80.

CONCLUSIONS:

Near-universal Medicare coverage at age 65 was associated with a reduction-but not elimination-of access and affordability problems among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS These findings reaffirm the role of Medicare in improving access and affordability for older cancer survivor and highlight opportunities for reforms to further alleviate financial burden of care in this population.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Cancer Surviv Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Cancer Surviv Ano de publicação: 2024 Tipo de documento: Article