Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer.
Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer.
复制标题
医疗补助的扩张与乳腺癌年轻人的治疗收据，及时性和结果有关。
DOI：
10.1093/jncics/pkad067
复制
发表时间：
2023-08-31
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
作者：
女性乳腺癌是年轻人中常见的癌症，这是未保险率最高的年龄组。 在2011年至2018年国家癌症数据库中诊断为乳腺癌的51675名年轻成年女性（年龄18-39岁）中，我们估计了与《平价医疗法案》医疗补助扩展相关的指南一致性治疗接受、治疗及时性和生存率的变化。在患有I-III期雌激素受体阳性或孕激素受体阳性乳腺癌的年轻人中，医疗补助扩张与接受内分泌治疗的百分比净增加2.42个百分点（95%置信区间[CI] = 0.56至4.28个百分点）相关。在所有患有I-III期乳腺癌的年轻人中，医疗补助的扩大与净减少1.65个百分点有关（95% CI = 0.08 - 3.22个百分点），治疗延迟定义为诊断后至少60天开始治疗，净增加1.00个百分点（95% CI = 0.21至1.79个百分点）。我们的研究提供了证据，证明癌症护理和医疗补助计划在年轻成年人中的扩展带来的益处。
Female breast cancer is a common cancer in young adults, an age group with the highest uninsured rate. Among 51 675 young adult women (ages 18-39 years) diagnosed with breast cancer between 2011 and 2018 in the National Cancer Database, we estimated changes in guideline-concordant treatment receipt, treatment timeliness, and survival associated with the Affordable Care Act Medicaid expansion. Of young adults with stage I-III estrogen receptor–positive or progesterone receptor–positive breast cancer, Medicaid expansion was associated with a net increase of 2.42 percentage points (95% confidence interval [CI] = 0.56 to 4.28 percentage points) in the percentage receiving endocrine therapy. Among all young adults with stage I-III breast cancer, Medicaid expansion was associated with a net reduction of 1.65 percentage points (95% CI = 0.08 to 3.22 percentage points) in treatment delays defined as treatment initiation of at least 60 days after diagnosis and a net increase of 1.00 percentage points (95% CI = 0.21 to 1.79 percentage points) in 2-year overall survival. Our study provides evidence of benefit in cancer care and outcomes from Medicaid expansion among the young adult population.
登录
查看更多内容
影响因子：
254.7
作者：
Miller, Kimberly D.;Fidler-Benaoudia, Miranda;Siegel, Rebecca L.
通讯作者：
Siegel, Rebecca L.
影响因子：
3.7
作者：
Mallin, Katherine;Browner, Amanda;Nelson, Heidi
通讯作者：
Nelson, Heidi
影响因子：
4
作者：
Smith-Graziani D;Lei X;Giordano SH;Zhao H;Karuturi M;Chavez-MacGregor M
通讯作者：
Chavez-MacGregor M
影响因子：
3.7
作者：
Han, Xuesong;Zhao, Jingxuan;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin
影响因子：
6.2
作者：
Robbins, Anthony S.;Lerro, Catherine C.;Barr, Ronald D.
通讯作者：
Barr, Ronald D.