Cancer survival in Kentucky and health insurance coverage


McDavid, K; Tucker, TC; Sloggett, A; Coleman, MP; (2003) Cancer survival in Kentucky and health insurance coverage. Archives of internal medicine, 163 (18). pp. 2135-2144. ISSN 0003-9926 DOI: 10.1001/archinte.163.18.2135

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Abstract

Background: Access to health insurance influences the amount and quality of health care received, which in turn is likely to be related to survival. Few studies have systematically examined cancer survival by individual level health insurance data from a state population-based cancer registry for 4 anatomic sites. Methods: Men and women aged 18 to 99 years who were registered from 1995 to 1998 with the Kentucky Cancer Registry, Lexington, with colorectal, lung, breast, or prostate cancer were followed up through 1999. Three-year crude and relative survival proportion by 7 health insurance categories and by sex for all 4 sites were calculated. Poisson regression was used to model the risk of death (controlling for age group at diagnosis, sex, race, stage at diagnosis, and treatment) relative to expected deaths in the general population from all 4 cancers by health insurance category. Results: Among patients with prostate cancer, 3-year relative survival proportion was 98% for the privately insured and 83% for the uninsured; comparable figures were 91% and 78% for patients with breast cancer; 71% and 53% for patients with colorectal cancer; and 23% and 13% for patients with lung cancer. For all 4 cancers the uninsured ranked fifth or sixth on survival, above patients with unknown insurance type or Medicaid/welfare. Conclusion: These findings confirm purported disparities in cancer care and point toward the need to make quality care accessible to all segments of the population.

Item Type: Article
Keywords: breast-cancer, social-class, prostate-cancer, united-states, socioeconomic-status, patient survival, care, outcomes, diagnosis, finland, Adolescent, Adult, Aged, Aged, 80 and over, Breast Neoplasms, mortality, Colorectal Neoplasms, mortality, Female, Health Services Accessibility, economics, Human, Insurance Coverage, Insurance, Health, Kentucky, epidemiology, Male, Medicaid, statistics & numerical data, Medically Uninsured, Medicare, statistics & numerical data, Middle Age, Neoplasms, economics, mortality, Prostatic Neoplasms, mortality, Registries, Regression Analysis
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Population Studies (1974-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Population Studies Group
Cancer Survival Group
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 14557210
Web of Science ID: 185931500006
URI: http://researchonline.lshtm.ac.uk/id/eprint/15889

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