医疗补助扩张增加了结肠癌患者的治疗费用
John Morgan Lyons1,2, Denise M Danos1,3, Lauren S Maniscalco3
1Department of Surgery, Louisiana State University Health Sciences Center, 2021 Perdido Street, 8th Floor, New Orleans, LA 70112, USA.
Cancers
|January 25, 2025
概括
医疗补助扩张 (ME) 增加了结肠癌治疗,特别是早期疾病的手术和年轻晚期患者的化疗. ME没有影响治疗的及时性,但有利于特定的人口群体.
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) 改善了结肠癌查率.
- ME对结肠癌治疗模式的影响仍然不太清楚.
- 这项研究调查了ME对结肠癌治疗方式的影响.
研究的目的:
- 分析医疗补助扩展对结肠癌治疗模式的影响.
- 为了确定特定的患者亚组,从ME中获益于治疗.
- 评估ME是否影响结肠癌治疗的及时性.
主要方法:
- 利用路易斯安那瘤登记处识别患有原发性侵袭性结肠癌的患者.
- 在前ME (2014-2015) 和后ME (2017-2018) 诊断期之间比较治疗模式.
- 采用多变量逻辑回归模型治疗状态,报告调整的几率比率.
主要成果:
- 降低了ME后的无保险率,特别是在年轻人,非裔美国人和高贫困地区.
- 在ME后的I-III期结肠癌患者中,手术的可能性增加 (OR=1.95),特别是极度贫困的患者 (OR=2.39).
- 年轻的IV期患者的化疗使用增加 (OR=1.6);整体IV期治疗30天内减少 (OR=0.7),主要是非医疗补助患者.
结论:
- 医疗补助扩张与结肠癌治疗利用率的增加有关.
- ME并没有对治疗开始的时间产生负面影响.
- ME对治疗的影响在不同的人口和社会经济小组之间有所不同.
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