医疗补助计划扩大与 HPB/GI 癌症手术：NCDB 双重差分分析。
Medicaid expansion and surgery for HPB/GI cancers: NCDB difference-in-difference analysis.
机构信息
Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
出版信息
Am J Surg. 2023 Feb;225(2):328-334. doi: 10.1016/j.amjsurg.2022.09.004. Epub 2022 Sep 14.
BACKGROUND
It is unclear if Medicaid expansion improved access to surgical resection for hepatopancreatobiliary (HPB) and gastrointestinal (GI) cancers.
METHODS
This was a quasi-experimental, cohort study using difference-in-difference analysis to evaluate differences in surgical resection for HPB/GI cancers in the post-Medicaid expansion era compared to the pre-Medicaid expansion era among patients residing in states that had Medicaid expansion versus not.
RESULTS
During the pre- (2011-2013) and post-Medicaid expansion (2015-2017) eras, there were 49,954 patients between the ages of 40-64 who had liver cancer (n = 19,384; 38.8%), pancreatic cancer (n = 14,351; 28.7%), colorectal liver metastasis (n = 7566; 15.1%), or gastric cancer (n = 8653; 17.3%). 43.2% resided in expansion states (n = 21,577). There were no significant differences in the overall rates of surgical resection between expansion and non-expansion states before and after Medicaid expansion.
CONCLUSIONS
Medicaid expansion did not impact surgical resection for HPB/GI cancers.
背景
尚不清楚医疗补助计划扩大是否改善了肝胆胰（HPB）和胃肠（GI）癌症的手术切除机会。
方法
这是一项准实验性队列研究，采用差异中的差异分析评估了医疗补助计划扩大前后，在接受医疗补助的州和未接受医疗补助的州中，HPB/GI 癌症手术切除的差异。
结果
在医疗补助计划扩大前（2011-2013 年）和扩大后（2015-2017 年）期间，年龄在 40-64 岁之间的患者有 49954 人患有肝癌（n=19384；38.8%）、胰腺癌（n=14351；28.7%）、结直肠癌肝转移（n=7566；15.1%）或胃癌（n=8653；17.3%）。43.2%的患者居住在扩大的州（n=21577）。在医疗补助计划扩大前后，扩大州和非扩大州的手术切除总体率没有显著差异。
结论
医疗补助计划扩大并未影响肝胆胰/胃肠癌症的手术切除。
Zotero 插件