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Medicaid expansion and surgery for HPB/GI cancers: NCDB difference-in-difference analysis
Zoey Kaelberer1, Mengyuan Ruan2, Miranda B Lam3
1Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Medicaid expansion did not affect surgical resection rates for hepatopancreatobiliary (HPB) and gastrointestinal (GI) cancers. This study found no significant differences in surgical access for these cancer types post-expansion.
Area of Science:
- Oncology
- Health Services Research
- Public Health Policy
Background:
- Access to surgical resection for hepatopancreatobiliary (HPB) and gastrointestinal (GI) cancers remains a critical concern.
- The impact of Medicaid expansion on surgical care for these specific cancer types is not well-established.
Purpose of the Study:
- To evaluate whether Medicaid expansion influenced the rates of surgical resection for HPB and GI cancers.
- To compare surgical resection rates before and after Medicaid expansion in states that expanded Medicaid versus those that did not.
Main Methods:
- A quasi-experimental, difference-in-difference analysis was employed.
- The study analyzed data from 49,954 patients aged 40-64 diagnosed with liver, pancreatic, colorectal liver metastasis, or gastric cancer between 2011-2013 (pre-expansion) and 2015-2017 (post-expansion).
- Patients were categorized based on residency in Medicaid expansion or non-expansion states.
Main Results:
- No significant differences were observed in the overall rates of surgical resection for HPB/GI cancers between expansion and non-expansion states.
- These findings held true for both the pre- and post-Medicaid expansion periods.
Conclusions:
- Medicaid expansion did not demonstrate a significant impact on the utilization of surgical resection for HPB/GI cancers.
- Further research may be needed to explore other factors influencing surgical access for these patient populations.
