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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Pannu, JS; Simpson, MC; Adjei Boakye, E; Massa, ST; Cass, LM; Challapalli, SD; Rohde, RL; Osazuwa-Peters, N

Published Date

  • July 2021

Published In

Volume / Issue

  • 43 / 7

Start / End Page

  • 2136 - 2147

PubMed ID

  • 33780066

Electronic International Standard Serial Number (EISSN)

  • 1097-0347

Digital Object Identifier (DOI)

  • 10.1002/hed.26682


  • eng

Conference Location

  • United States