Relationship between Insurance Type at Diagnosis and Hepatocellular Carcinoma Survival.
Cancer Epidemiol Biomarkers Prev
; 29(2): 300-307, 2020 02.
Article
em En
| MEDLINE
| ID: mdl-31796525
ABSTRACT
BACKGROUND:
For individuals with hepatocellular carcinoma (HCC), type of insurance may be an important prognostic factor because of its impact on access to care. This study investigates the relationship between insurance type at diagnosis and stage-specific survival.METHODS:
This retrospective cohort analysis used data from 18 Surveillance, Epidemiology, and End Results Program cancer registries. Individuals ages 20 to 64 years, diagnosed with primary HCC between 2010 and 2015, with either private, Medicaid, or no insurance were eligible for cohort inclusion. Adjusted Cox proportional-hazards regression models were used to generate HRs and 95% confidence intervals (CI) for associations between insurance type at diagnosis and overall survival. All models were stratified by stage at diagnosis.RESULTS:
This analysis included 14,655 cases. Compared with privately insured individuals with the same stage of disease, those with Medicaid had a 43% (HR = 1.43; 95% CI, 1.13-1.32), 22% (HR = 1.22; 95% CI, 1.13-1.32), and 7% higher risk of death for localized, regional, and distant stage, respectively. Uninsured individuals had an 88% (HR = 1.88; 95% CI, 1.65-2.14), 59% (HR = 1.59; 95% CI, 1.41-1.80), and 35% (HR = 1.35; 95% CI, 1.18-1.55) higher risk of death for localized, regional, and distant stage, respectively, compared with privately insured individuals.CONCLUSIONS:
Disparities in survival exist by the type of insurance that individuals with HCC have at the time of diagnosis. IMPACT These findings support the need for additional research on access to and quality of cancer care for Medicaid and uninsured patients.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Medicaid
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Pessoas sem Cobertura de Seguro de Saúde
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Carcinoma Hepatocelular
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Cobertura do Seguro
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Seguro Saúde
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Neoplasias Hepáticas
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article