对于患有癌症的医疗保险受益人来说,治疗选择的质量
Aaron P Mitchell1,2, Sonia Persaud1, Akriti Mishra Meza1
1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
概括
低收入补贴 (LIS) 的参与与减少接受全身癌症治疗以及接受低于最佳治疗的可能性更高有关. 这影响了弱势群体获得癌症护理的机会.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 医疗保险D部分低收入补贴 (LIS) 提高了获得口腔癌药物的机会.
- 医疗保险不涵盖临床医生使用的B部分癌症药物,造成了潜在的护理差异.
- 优化癌症治疗对患者的治疗结果至关重要,并涉及全身疗法.
研究的目的:
- 评估参与医疗保险D部分低收入者补贴 (LIS) 计划和获得最佳癌症治疗之间的关联.
- 调查LIS受益人是否以与非LIS受益人相比的速度接受全身癌症治疗.
- 确定LIS参与是否会影响处方癌症治疗的质量.
主要方法:
- 利用了2015-2017年的SEER-Medicare数据,涉及11个癌症临床场景中的9290名患者.
- 使用国家综合癌症网络 (NCCN) 证据块 (EB) 和ASCO价值框架定义了最佳治疗方法.
- 使用后勤回归来建模接受任何全身疗法与不接受任何疗法的可能性,以及接受治疗的质量.
主要成果:
- 57%的患者接受了全身疗法;43%没有.
- 与非LIS参与者相比,LIS参与者接受任何全身治疗的可能性降低了36% (OR 0.64).
- 在接受治疗的人中,LIS参与者更有可能接受NCCNEB分数最低四分位数的治疗 (4.3%更高的患病率).
结论:
- 参与医疗保险D部分低收入补贴 (LIS) 与接受全身癌症治疗的可能性降低有关.
- LIS受益者更容易接受低效率和安全性得分的癌症治疗.
- 这些发现凸显了LIS注册患者在癌症治疗获取和质量的潜在不平等.
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