Evidence map›Paper›PMID 27072683›Full record

ArticleJournal of cancer survivorship : research and practice2016

Health insurance coverage, care accessibility and affordability for adult survivors of childhood cancer: a cross-sectional study of a nationally representative database.

Karen A Kuhlthau, Ryan D Nipp, Amy Shui, Sean Srichankij, Anne C Kirchhoff, Alison A Galbraith, Elyse R Park

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cancer survivorship : research and practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05527392 (Assessing the Effect of Virtual Navigation Interventions to Improve Health Insurance Literacy and Decrease Financial Burden), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05527392 naactive not recruitingnot on this mapstarted 2023, after this paper: background citation

Assessing the Effect of Virtual Navigation Interventions to Improve Health Insurance Literacy and Decrease Financial Burden: A Childhood Cancer Survivor Study Randomized Trial (HINTII)

TypeinterventionalSponsorMassachusetts General HospitalRan2023 to 2027Enrolled529ConditionsChildhood Cancer SurvivorsArmsHealth Insurance Navigation Tools Program
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Development of a Health Insurance Navigation Program for Long-Term Childhood Cancer Survivors.Health education & behavior : the official publication of the Society for Public Health Education · 2025
    Article
  7. Article
  8. Article
  9. Article
  10. Financial Burden in Blood or Marrow Transplantation Survivors During the COVID-19 Pandemic: A BMTSS Report.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023
    Article
  11. Article
  12. Article
  13. Studying Healthcare Affordability during an Economic Recession: The Case of Greece.International journal of environmental research and public health · 2020
    Article
  14. Article
  15. Article
  16. Patterns of family management for adolescent and young adult brain tumor survivors.Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) · 2018
    Article
  17. Review
  18. Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2017
    Article
  19. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Karen A KuhlthauDepartment of Pediatrics, Massachusetts General Hospital (MGH), and Harvard Medical School (HMS), 125 Nashua Street, Suite 860, Boston, MA, 01224, USA. kkuhlthau@mgh.harvard.edu.
Ryan D NippClinical Fellow in Oncology, MGH Cancer Center, Yawkey 10B, Boston, MA, 02114, USA.
Amy ShuiMGH Biostatistics Center, 50 Staniford Street, Suite 560, Boston, MA, 02114, USA.
Sean SrichankijDepartment of Medicine, Columbia University Medical Center, 180 Fort Washington Avenue Room 924, New York, NY, 10032, USA.
Anne C KirchhoffDepartment of Pediatric Hematology/Oncology, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4145, Salt Lake City, UT, 84112, USA.
Alison A GalbraithHMS and Harvard Pilgrim Health Care Institute, Department of Population Medicine, Landmark Center, 401 Park Drive Suite 401, Boston, MA, 02215, USA.
Elyse R ParkDepartment of Psychiatry, MGH and HMS, 50 Staniford Street, Room 907, Boston, MA, 02114, USA.

Funding

Examining Delivery of Integrated Tobacco Treatment in Cancer CareK24CA197382 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI PARK, ELYSE R. · 2015 to 2019
$841k
NCI NIH HHS K24 CA197382
6 · The paper itself

Abstract

purposeWe describe national patterns of health insurance coverage and care accessibility and affordability in a national sample of adult childhood cancer survivors (CCS) compared to adults without cancer.

methodsUsing data from the 2010-2014 National Health Interview Survey (NHIS), we selected a sample of all CCS age 21 to 65 years old and a 1:3 matched sample of controls without a history of cancer. We examined insurance coverage, care accessibility and affordability in CCS and controls. We tested for differences in the groups in bivariate analyses and multivariable logistic regression models.

resultsOf all respondents age 21-65 in the full NHIS sample, 443 (0.35 %) were CCS. Fewer CCS were insured (76.4 %) compared to controls (81.4 %, p = 0.067). Significantly more CCS reported delaying medical care (24.7 vs 13.0 %), needing but not getting medical care in the previous 12 months (20.0 vs 10.0 %), and having trouble paying medical bills (40.3 vs 19.7 %) compared to controls (p < 0.0001 for all). More CCS reported trouble with care affordability in the previous 12 months compared to controls on six categories of care and for a combined measure of affordability (p < 0.0001 for composite of all). Adjusted analyses demonstrated that these differences comparing CCS to controls remained significant.

conclusionsCCS report problems with health care accessibility and affordability. These analyses support the development of policies to assure that CCS have access to affordable services. IMPLICATIONS FOR CANCER SURVIVORS: Efforts to improve access to high-quality and affordable insurance for CCS may help reduce the gaps in getting medical care and problems with affordability. Health care providers should be aware that such problems exist and should discuss affordability and ability to obtain care with patients.

Indexed as

AdultAgedCross-Sectional StudiesFemaleHealth Services AccessibilityHumansInsurance CoverageInsurance, HealthMaleMiddle AgedNeoplasmsSurvivorsYoung AdultAccessAffordabilityChildhood cancer survivorsInsurancePediatricSurvivorship

Identifiers

PMID27072683
PMCPMC8109280

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.