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“医疗保险效应”对头颈部癌症诊断和生存的影响。

The "Medicare effect" on head and neck cancer diagnosis and survival.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA.

出版信息

Head Neck. 2023 Jul;45(7):1663-1675. doi: 10.1002/hed.27379. Epub 2023 Apr 25.

Abstract

BACKGROUND

Uninsured individuals age 55-64 experience disproportionately poor outcomes compared to their insured counterparts. Adequate coverage may prevent these delays. This study investigates a "Medicare-effect" on head and neck squamous cell carcinoma (HNSCC) diagnosis and treatment.

METHODS

The Surveillance, Epidemiology, and End Results (SEER) database was queried for persons ages 60-70 years in the United States from 2000 to 2016 with HNSCC. A "Medicare effect" was defined as an increase in incidence, reduction in advanced stage presentation, and/or decrease in cancer-specific mortality (CSM).

RESULTS

Compared to their Medicaid or uninsured counterparts, patients age 65 have an increased incidence of HNSCC diagnosis, reduction in advanced stage presentation, decrease in cancer-specific mortality, and higher likelihood of receiving cancer-specific surgery.

CONCLUSIONS

Patients age 65 with Medicare have decreased incidence of HNSCC, less hazard of late-stage diagnosis, and lower cancer-specific mortality than their Medicaid or uninsured counterparts, supporting the idea of a "Medicare effect" in HNSCC.

摘要

背景

与已参保者相比,55-64 岁的未参保者的预后明显较差。充分的保障可能会避免这些延误。本研究调查了“医疗保险效应”对头颈部鳞状细胞癌(HNSCC)诊断和治疗的影响。

方法

本研究在美国,从 2000 年到 2016 年,使用监测、流行病学和最终结果(SEER)数据库对年龄在 60-70 岁之间的 HNSCC 患者进行了调查。将“医疗保险效应”定义为发病率增加、晚期表现减少和/或癌症特异性死亡率(CSM)降低。

结果

与 Medicaid 或未参保者相比,65 岁以上的患者 HNSCC 诊断的发病率增加,晚期表现减少,癌症特异性死亡率降低,接受癌症特异性手术的可能性更高。

结论

与 Medicaid 或未参保者相比,65 岁以上的 Medicare 患者 HNSCC 的发病率降低,晚期诊断的风险降低,癌症特异性死亡率降低,支持 HNSCC 存在“医疗保险效应”的观点。

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