Improved Five-year Cancer Survival Observed After Medicaid Expansion

Bottom Line: Adoption of Medicaid description successful U.S. states appeared to amended some five-year cause-specific and wide endurance successful crab patients.

Journal successful Which nan Study was Published: Cancer Discovery, a diary of nan American Association for Cancer Research (AACR)

Author: Elizabeth Schafer, MPH, subordinate intelligence astatine nan American Cancer Society

Background: In 2014, a proviso nether nan Patient Protection and Affordable Care Act (ACA) went into effect that allowed states to opt into expanding Medicaid eligibility to adults pinch incomes up to 138% of nan national poorness guidelines. Existing studies person linked Medicaid description to accrued security coverage, entree to crab screening services, and improved two-year endurance rates, but its effect connected longer-term endurance among individuals diagnosed pinch crab remains unknown, according to Schafer.

How nan study was conducted: To reply their question, Schafer and her coauthors utilized a difference-in-differences (DD) study creation that compared information from states during 2007-2008-a play anterior to Medicaid description -with information from 2014-2015, erstwhile galore states adopted nan description . This creation allowed nan investigation squad to dainty Medicaid description akin to an experimental involution pinch effects that could beryllium measured against a power group of states that had not enacted nan description .

Using nan Cancer successful North America Survival dataset, Schafer and her coauthors analyzed information from 1,423,983 crab cases diagnosed successful adults aged 18 to 59 years and compared five-year endurance from follow-up information obtained successful nan years pursuing some nan 2007-2008 cohort and nan 2014-2015 cohort. The study assessed and compared 26 description states pinch 12 states that did not grow Medicaid astatine that time.

In nan discourse of Schafer's study, results presented arsenic percent points (ppt) successful DD are nan subtraction of nan quality betwixt description states and nonexpansion states successful 2007-2008 from nan quality betwixt description and nonexpansion states successful 2014-2015. DD of endurance measurements shows whether Medicaid description correlates pinch nan trajectory of endurance rates comparative to states wherever it was not adopted.

Results: After adjusting for covariates, nan researchers observed that, among crab patients surviving successful agrarian areas, Medicaid description was associated pinch important DD improvements successful cause-specific and wide endurance of 2.55 ppt and 3.03 ppt, respectively. Similarly, patients surviving successful high-poverty areas successful states pinch Medicaid description knowledgeable important DD improvements successful cause-specific and wide survival: 1.54 ppt and 1.69 ppt, respectively.

Patients pinch cancers associated pinch higher mortality besides knowledgeable important improvements successful some cause-specific and wide endurance if they lived successful Medicaid description states.

Overall endurance among non-Hispanic Black individuals was besides importantly higher successful Medicaid description states, pinch a DD of 1.05 ppt. Expansion was associated pinch important increases successful some cause-specific and wide endurance successful non-Hispanic Whites arsenic well, pinch DDs of 0.37 ppt and 0.57 ppt, respectively. In description states, an adjusted cause-specific endurance betterment was observed for each crab patients irrespective of individual variables, but nan betterment was not statistically significant.

Author's comments: "Studying nan effect of Medicaid description connected longer-term endurance outcomes among individuals diagnosed pinch crab is important for guiding evidence-based decision-making by policymakers and advocates for maintaining and expanding Medicaid," Schafer said.

"The grounds supporting Medicaid description successful improving outcomes for crab patients is clear," she added. "Research has shown that Medicaid description tin summation crab screening prevalence, early-stage diagnosis, short-term survival, and now-according to our ain analysis-five-year survival. These findings underscore nan value of protecting and expanding Medicaid successful nan remaining 10 nonexpansion states to amended outcomes for each individuals."

Study limitations: Limitations of nan study see nan imaginable confounding facet of nan ACA's wide broadening of wellness security coverage, arsenic much group pinch wellness security and entree to early crab discovery and curen could skew nan data. Additionally, nan dataset besides excluded individuals pinch missing cause-of-death and sociodemographic information.