RESUMO
BACKGROUND: Colon cancer is the third most frequent cancer diagnosis, and primary payer status has been shown to be associated with treatment modalities and survival in cancer patients. The goal of our study was to determine the between-insurance differences in survival in patients with clinical stage III colon cancer using data from the National Cancer Database (NCDB). MATERIALS AND METHODS: We identified 130,998 patients with clinical stage III colon cancer in the NCDB diagnosed from 2004 to 2012. Kaplan-Meier curves and multivariable Cox regression models were used to determine the association between insurance status and survival. RESULTS: Patients with private insurance plans were 28%, 30%, and 16% less likely to die than were uninsured patients, Medicaid recipients, and Medicare beneficiaries, respectively. Medicare patients were 14% were less likely to die compared with uninsured patients. Patients receiving chemotherapy were, on average, 65% less likely to die compared with the patients not receiving chemotherapy. CONCLUSION: Private insurance and a greater socioeconomic status were associated with increased patient survival compared with other insurance plans or the lack of insurance. Future research should continue to unravel how socioeconomic status and insurance status contribute to the quality of care and survival of oncologic patients.
Assuntos
Neoplasias do Colo/economia , Neoplasias do Colo/mortalidade , Bases de Dados Factuais , Cobertura do Seguro/economia , Seguro Saúde/economia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/patologia , Neoplasias do Colo/terapia , Feminino , Seguimentos , Humanos , Masculino , Medicaid , Pessoas sem Cobertura de Seguro de Saúde , Medicare , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Taxa de Sobrevida , Estados UnidosRESUMO
BACKGROUND: The importance of socioeconomic factors and healthcare treatment and outcomes for lower income patients is tremendous, affecting not only those afflicted by poverty and decreased quality of care but also physicians, healthcare professionals, and society at large. METHODS: The National Cancer Database was used to identify 80,907 patients with stage 0-4 melanoma and analyze variables to track patterns in survival and outcome. RESULTS: This study demonstrates that disparities in income, insurance status, and education affects treatment and survival rates across all stages of melanoma and seeks to establish further understanding surrounding socioeconomic factors and quality of healthcare in America. CONCLUSION: Through investigation and analysis, the goal of this study is to highlight how the existing socioeconomic gap in America impacts the quality of treatment and survival in patients diagnosed with melanoma.