a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China.
b Department of Dermatology , Yale School of Medicine , New Haven , CT , USA.
Leuk Lymphoma. 2019 May;60(5):1253-1260. doi: 10.1080/10428194.2018.1520987. Epub 2018 Oct 16.
The effect of insurance status on overall survival (OS) of patients with cutaneous T-cell lymphoma (CTCL) is unclear. We identified 11,861 patients from the US National Cancer Data Base diagnosed with CTCL from 2004-2014, of which 6088 had private insurance, 756 had Medicaid, 4536 had Medicare, and 481 are uninsured. Privately insured patients were more likely to present at an early stage (p < .001). On multivariate Cox regression analysis, privately insured patients had significantly longer OS than patients with Medicaid (HR: 1.936, 95% CI: 1.680-2.230, p < .001), Medicare (HR: 1.342, 95% CI: 1.222-1.474, p < .001), or no insurance (HR 1.849, 95% CI: 1.539-2.222, p < .001). The survival advantage of privately insured patients persisted on relative survival and propensity score-matched analyses. In conclusion, privately insured patients were more likely to present at an early stage, and had longer OS than patients who were Medicaid-, Medicare-, or not insured.
保险状况对皮肤 T 细胞淋巴瘤 (CTCL) 患者总生存 (OS) 的影响尚不清楚。我们从美国国家癌症数据库中确定了 11861 名 2004 年至 2014 年间诊断为 CTCL 的患者，其中 6088 人有私人保险，756 人有医疗补助，4536 人有医疗保险，481 人没有保险。有私人保险的患者更有可能处于早期阶段（p<0.001）。在多变量 Cox 回归分析中，有私人保险的患者的 OS 明显长于有医疗补助（HR：1.936，95%CI：1.680-2.230，p<0.001）、医疗保险（HR：1.342，95%CI：1.222-1.474，p<0.001）或没有保险（HR 1.849，95%CI：1.539-2.222，p<0.001）的患者。相对生存率和倾向评分匹配分析均显示，私人保险患者的生存优势持续存在。总之，有私人保险的患者更有可能处于早期阶段，并且 OS 长于有医疗补助、医疗保险或没有保险的患者。
