Al-Qurayshi Zaid, Sullivan Christopher B, Shama Mohamed A, Pagedar Nitin A, Kandil Emad
Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.
Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.
Laryngoscope. 2023 Jun;133(6):1409-1414. doi: 10.1002/lary.30314. Epub 2022 Aug 3.
Under the Affordable Care Act (ACA), Medicaid expansion became effective in states that have adopted it. We aim to examine its impact on head and neck cancers.
A retrospective study that utilizes the Surveillance, Epidemiology, and End Results database, 2010-2016. Study population included patients with head and neck squamous cell carcinoma (HNSCC), differentiated thyroid carcinoma, and head and neck cutaneous melanoma. The objective is to examine disease-specific survival before and after Medicaid expansion.
In states that adopted Medicaid expansion, the ratio of Medicaid: uninsured patients increased from 3:1 to 9:1 (p < 0.001). In states that did not adopt Medicaid expansion, the ratio increased from 1:1 to 2:1 (p < 0.001), making the increase in Medicaid coverage in states that adopted the expansion significantly higher (p < 0.001). Patients diagnosed with HNSCC before the expansion had worse survival (hazard ratio [HR]: 1.24, 95% confidence interval: 1.11, 1.39, p < 0.001) in states that adopted Medicaid expansion.
Early data indicate that implementation of ACA improved disease-specific survival of patients with HNSCC.
3 Laryngoscope, 133:1409-1414, 2023.
根据《平价医疗法案》（ACA），医疗补助扩大计划在已采用该计划的州生效。我们旨在研究其对头颈部癌症的影响。
一项回顾性研究，利用2010 - 2016年的监测、流行病学和最终结果数据库。研究人群包括头颈部鳞状细胞癌（HNSCC）、分化型甲状腺癌和头颈部皮肤黑色素瘤患者。目的是研究医疗补助扩大计划实施前后特定疾病的生存率。
在采用医疗补助扩大计划的州，医疗补助患者与未参保患者的比例从3:1增至9:1（p < 0.001）。在未采用该计划的州，这一比例从1:1增至2:1（p < 0.001），这使得采用该计划的州医疗补助覆盖范围的增加显著更高（p < 0.001）。在采用医疗补助扩大计划的州，在扩大计划实施前被诊断为HNSCC的患者生存率较差（风险比[HR]：1.24，95%置信区间：1.11，1.39，p < 0.001）。
早期数据表明，ACA的实施改善了HNSCC患者的特定疾病生存率。
3 喉镜，133:1409 - 1414，2023年。
