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
Language
- eng
Conference Location
- United States