Disparities in Survival by Insurance Status in Patients With Hodgkin Lymphoma

Grossbard, Michael L.; Harrison, Louis B.; Yahalom, J

doi:10.1016/j.ijrobp.2015.07.1692

Cited by 8 publications

(15 citation statements)

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“…Furthermore, this is indicative of flaws within the diagnostic and treatment process for Black patients. Over the next decade, improved access to healthcare as a result of the Affordable Health Care Act could potentially alter these diagnostic and treatment disparities . Identification of sociocultural factors and health behaviors that negatively affect survival in this population are complicated and should be a focus of further study.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population

Grubb

Neboori

Diaz

et al. 2015

Pediatr Blood Cancer

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Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population

Grubb

Neboori

Diaz

et al. 2015

Pediatr Blood Cancer

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“…A few studies about the impact of SES on HL outcomes have been performed . Different strategies for SES stratification have been used in these studies, including the neighborhood SES, racial/ethnic differences, the medical insurance status and specific local measures, such as the Ontario Marginalization Index.…”

Section: Discussionmentioning

confidence: 99%

“…Socioeconomic status (SES), a wide concept including both economic and social resources, is a strong predictor of morbidity and premature mortality worldwide, and a well‐known determinant of outcomes in cancer . There is a growing body of evidence suggesting substantial disparities in cancer treatment outcomes determined by economic and social factors, even within developed nations . Inequalities in survival according to socioeconomic status in lymphoma patients have also been reported …”

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confidence: 99%

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Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients—An analysis from the Brazilian Hodgkin Lymphoma Registry

Biasoli

Castro

Delamain

et al. 2017

Intl Journal of Cancer

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Socioeconomic status (SES) is a well-known determinant of outcomes in cancer. The purpose of this study was to analyze the impact of the SES on the outcomes of Hodgkin lymphoma (HL) patients from the Brazilian Prospective HL Registry. SES stratification was done using an individual asset/education-based household index. A total of 624 classical HL patients with diagnosis from January/2009 to December/2014, and treated with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine), were analyzed. The median follow-up was 35.6 months, and 33% were classified as lower SES. The 3-year progression- free survival (PFS) in higher and lower SES were 78 and 64% (p < 0.0001), respectively. The 3-year overall survival (OS) in higher and lower SES were 94 and 82% (p < 0.0001), respectively. Lower SES patients were more likely to be ≥ 60 years (16 vs. 8%, p = 0.003), and to present higher risk International Prognostic score (IPS) (44 vs. 31%, p = 0.004) and advanced disease (71 vs. 58%, p = 0.003). After adjustments for potential confounders, lower SES remained independently associated with poorer survival (HR = 3.12 [1.86-5.22] for OS and HR = 1.66 [1.19-2.32] for PFS). The fatality ratio during treatment was 7.5 and 1.3% for lower and higher SES (p = 0.0001). Infections and treatment toxicity accounted for 81% of these deaths. SES is an independent factor associated with shorter survival in HL in Brazil. Potential underlying mechanisms associated with the impact of SES are delayed diagnosis and poorer education. Educational and socio-economic support interventions must be tested in this vulnerable population.

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“…Medicaid insurance is offered to approximately 10 million older adults who live at less than 133% of the federal poverty level . Compared with older adult Medicare beneficiaries with commercial insurance, those with Medicaid are more likely to die from early‐stage lung cancer, lymphoma, and have worse outcomes after acute coronary syndrome . Older adult Medicare beneficiaries with Medicaid were also found to receive lower quality outpatient preventive care …”

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confidence: 99%

Health Insurance and Disparities in Mortality among Older Survivors of Critical Illness: A Population Study

Philpotts

Anderson

et al. 2019

J American Geriatrics Society

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Objectives The 1.5 million Medicare beneficiaries who survive intensive care each year have a high post‐hospitalization mortality rate. We aimed to determine whether mortality after critical illness is higher for Medicare beneficiaries with Medicaid compared with those with commercial insurance. Design A retrospective cohort study from 2010 through 2014 with 1 year of follow‐up using the New York Statewide Planning and Research Cooperative System database. Setting A New York State population‐based study of older (age ≥65 y) survivors of intensive care. Participants Adult Medicare beneficiaries age 65 years or older who were hospitalized with intensive care at a New York State hospital and survived to discharge. Intervention None. Measurement Mortality in the first year after hospital discharge. Results The study included 340 969 Medicare beneficiary survivors of intensive care with a mean (standard deviation) age of 77 (8) years; 20% died within 1 year. There were 152 869 (45%) with commercial insurance, 78 577 (23%) with Medicaid, and 109 523 (32%) with Medicare alone. Compared with those with commercial insurance, those with Medicare alone had a similar 1‐year mortality rate (adjusted hazard ratio [aHR] = 1.01; 95% confidence interval [CI] = .99‐1.04), and those with Medicaid had a 9% higher 1‐year mortality rate (aHR = 1.09; 95% CI = 1.05‐1.12). Among those discharged home, the 1‐year mortality rate did not vary by insurance coverage, but among those discharged to skilled‐care facilities (SCFs), the 1‐year mortality rate was 16% higher for Medicaid recipients (aHR = 1.16; 95% CI = 1.12‐1.21; P for interaction <.001). Conclusions Older adults with Medicaid insurance have a higher 1‐year post‐hospitalization mortality compared with those with commercial insurance, especially among those discharged to SCFs. Future studies should investigate care disparities at SCFs that may mediate these higher mortality rates. J Am Geriatr Soc 67:2497–2504, 2019

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Disparities in Survival by Insurance Status in Patients With Hodgkin Lymphoma

Cited by 8 publications

References 0 publications

Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population

Racial and Ethnic Disparities in the Pediatric Hodgkin Lymphoma Population

Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients—An analysis from the Brazilian Hodgkin Lymphoma Registry

Health Insurance and Disparities in Mortality among Older Survivors of Critical Illness: A Population Study

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