Herbert Wertheim College of Medicine, Department of Medical and Population Health Sciences Research, 11200 SW 8th Street, Miami, FL, 33199, United States.
Herbert Wertheim College of Medicine, Department of Medical and Population Health Sciences Research, 11200 SW 8th Street, Miami, FL, 33199, United States.
Leuk Res. 2021 May;104:106542. doi: 10.1016/j.leukres.2021.106542. Epub 2021 Feb 19.
Multiple myeloma (MM) accounts for 10 % of all hematological malignancies. As recent advances in MM treatment continue to improve survival rates, socioeconomic barriers need to be identified to ensure equal treatment. This study evaluates the association between insurance status and survival in patients with MM.
This study analyzed patients with MM from the 2007-2016 Surveillance, Epidemiology, and End Results (SEER) Program database. Insurance status was categorized as uninsured, Medicaid, private insurance, and other insurance. Cancer-specific survival was measured at one- and five-years post diagnosis.
From 2007-2016, there were 41,846 patients with MM extracted from the SEER database. Those with private insurance had a higher proportion of participants that identified as married (65.5 %), resided in metropolitan cities (90.1 %), and identified as white (76 %) and non-Hispanic (90.8 %). The uninsured group had the highest proportion of Black participants compared to other insurance groups (37.4 %). After adjustment for age, sex, race, ethnicity, marital status, and residence, the likelihood of five-year survival was significantly lower in those respondents with Medicaid (adjusted (adj) Hazard Ratio (HR): 1.44; 95 % Confidence Interval (CI): 1.36-1.53), when compared with private insurance holders. Those who were uninsured had a 26 % increased mortality hazard than those with private insurance (95 % CI 1.04-1.53).
After adjustment, insurance status can influence the survival of adults with MM. As treatment modalities for MM continue to advance, the insurance status of a patient should not hinder their ability to receive the most effective and timely therapies.
多发性骨髓瘤（MM）占所有血液系统恶性肿瘤的 10%。随着 MM 治疗的最新进展不断提高生存率，需要确定社会经济障碍，以确保公平治疗。本研究评估了 MM 患者的保险状况与生存之间的关系。
本研究分析了来自 2007-2016 年监测、流行病学和最终结果（SEER）计划数据库的 MM 患者。将保险状况分为无保险、医疗补助、私人保险和其他保险。在诊断后一年和五年测量癌症特异性生存率。
2007-2016 年，从 SEER 数据库中提取了 41846 例 MM 患者。私人保险的参与者中有更高比例的已婚者（65.5%）、居住在大都市（90.1%）、白种人（76%）和非西班牙裔（90.8%）。与其他保险组相比，无保险组的黑人参与者比例最高（37.4%）。在调整年龄、性别、种族、民族、婚姻状况和居住地后，与私人保险持有者相比，医疗补助的受访者五年生存率显著降低（调整后的危险比（HR）：1.44；95%置信区间（CI）：1.36-1.53）。与私人保险持有者相比，无保险者的死亡风险增加了 26%（95%CI 1.04-1.53）。
调整后，保险状况会影响 MM 成年患者的生存。随着 MM 治疗方法的不断进步，患者的保险状况不应阻碍他们获得最有效和及时的治疗的能力。
