Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.
JAMA Surg. 2013 Jun;148(6):570-2. doi: 10.1001/jamasurg.2013.61.
The effect of insurance payer status on surgical treatment of early stage breast cancer is unclear. This retrospective study examined the effect of insurance payer on mastectomy rates of 1539 women treated within a single health system. Women with Medicaid had significantly larger tumors compared with those with private insurance (PI) at diagnosis (3.3 cm vs 2.1 cm, P < .05) and were more likely to be treated with mastectomy for larger tumors compared with women with PI. However, women with PI were more likely to have mastectomy for smaller tumors; among women with tumors less than 2 cm, 11% with Medicaid underwent mastectomy compared with 47% with PI (P < .05). Overall, when compared with those with PI, women with Medicaid were more likely to receive mastectomy (60% vs 39%, P < .05).
保险支付方状态对早期乳腺癌手术治疗的影响尚不清楚。本回顾性研究调查了保险支付方对单一医疗体系内 1539 名女性的乳房切除术率的影响。与私人保险（PI）相比，医疗补助（Medicaid）女性在诊断时肿瘤明显更大（3.3cm 与 2.1cm，P < 0.05），并且更有可能因更大的肿瘤而接受乳房切除术治疗。然而，PI 女性更有可能因较小的肿瘤而接受乳房切除术；在肿瘤小于 2cm 的女性中，11%的 Medicaid 女性接受了乳房切除术，而 47%的 PI 女性接受了乳房切除术（P < 0.05）。总体而言，与 PI 女性相比，Medicaid 女性更有可能接受乳房切除术（60%与 39%，P < 0.05）。
