医疗补助计划的扩大和治疗晚期肝癌的息治疗
Henrique A Lima1, Parit Mavani2, Muhammad Musaab Munir2
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, United States; Department of Surgery, Federal University of Minas Gerais School of Medicine, Belo Horizonte, Brazil.
医疗补助扩张增加了晚期肝癌患者的息治疗. 然而,尽管扩大了这一关键治疗的机会,种族差异仍然存在.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗补助扩张 (ME) 重塑了美国的医疗保健.
- 在此之前,ME对原发性肝癌的息治疗的影响是未知的.
- 这项研究调查了ME和在晚期肝癌中接受息治疗之间的关联.
研究的目的:
- 评估医疗补助扩张和息治疗之间的关联.
- 确定ME是否影响肝癌患者获得息治疗的机会.
- 为了分析缓解护理利用率在医疗补助后扩张的变化.
主要方法:
- 利用国家癌症数据库对第四阶段肝细胞癌和肝内胆管癌患者.
- 将患者分为扩张前 (2010-2013) 和扩张后 (2015-2019) 的队列.
- 使用后勤回归和差异分析 (DID) 来评估息治疗的使用情况.
主要成果:
- 缓和治疗率在ME后增加 (18.1%至22.3%),ME状态的增加更大.
- 在ME之后,种族,保险,位置,癌症类型和ME状态与息治疗有关.
- 调整后的DID分析显示,ME患者的息治疗增加了4.4%,但种族差异仍然存在.
结论:
- 医疗补助扩张与扩张州肝癌患者的息治疗率更高有关.
- 尽管获得了更多的治疗机会,但在息治疗方面仍然存在显著的种族差异.
- 在医疗补助扩张后,公平获得息治疗仍然是一个挑战.
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