Effect of Medicaid Expansions of 2014 on Overall and Early-Stage Cancer Diagnoses
Effect of Medicaid Expansions of 2014 on Overall and Early-Stage Cancer Diagnoses
复制标题
DOI：
10.2105/ajph.2017.304166
复制
发表时间：
2018-02-01
影响因子：
12.7
通讯作者：
Sabik, Lindsay
中科院分区：
文献类型：
--
作者：
Soni, Aparna;Simon, Kosali;Sabik, Lindsay
目的，以确定是否2014年医疗补助扩张促进了平价医疗法案影响整体和早期癌症诊断的非老年人。我们使用了2010年至2014年的监测、临床和最终结果癌症登记数据来估计癌症诊断率的差异模型，包括整体和阶段，比较了2014年扩大医疗补助的美国各州与没有扩大医疗补助的州的县级诊断率的变化。在这项研究的611个县中，医疗补助的扩大与每10万人口中13.8例癌症诊断的总体增加相关（95%置信区间[CI] = 0.7，76.9），或3A%。医疗补助的扩大也与早期诊断的增加有关，每10万人中有15.4人（95% CI = 5A，25.3）或6.4%。对晚期诊断无明显影响。结论。在他们的第一年，我们7014医疗补助扩张与癌症诊断的增加有关，特别是在早期阶段，在工作年龄人口中。公共卫生影响。扩大公共医疗保险可能是改善癌症检测的一种途径，这与改善患者预后有关，包括降低死亡率。
Objectives, To determine whether the 2014 Medicaid expansions Facilitated by the Affordable Care Act affected overall and early-stage cancer diagnosis for nonelderly adults.Methods. We used Surveillance, Fpiclerriology, and End Results Cancer Registry data From 2010 through 2014 to estimate a difference-in-differences model of cancer diagnosis rates, both overall and by stage, comparing changes in county-level diagnosis rates in US states that expanded Medicaid in 2014 with those that did not expand Medicaid.Results. Among the 611 counties in this study, Medicaid expansion was associated with an increase in overall cancer diagnoses of 13.8 per 100 000 population (95% confidence interval [CI] = 0.7,76.9), or 3A%. Medicaid expansion was also associated with an increase in early-stage diagnoses of 15.4 per 100 000 population (95% CI = 5A, 25.3), or 6.4%. There was no detectable impact on late-stage diagnoses.Conciusions. In their first year, We 7014 Medicaid expansions were associated with an increase in cancer diagnosis, particularly at the early stage, in the working age population. Pubic Health Implications. Expanding public health insurance may be an avenue For improving cancer detection, which is associated with improved patient outcomes, including reduced mortality.