ArticleJournal of the American College of Surgeons2018
Medicaid Expansion and Disparity Reduction in Surgical Cancer Care at High-Quality Hospitals.
Article in Journal of the American College of Surgeons, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Article
- A Rising Tide Raises All Ships: Was the Effect of Medicaid Expansion on Cancer Outcomes Similar Across Subgroups of Patients With Cancer on Medicaid?AJPM focus · 2025Article
- Association of Medicaid Expansion With Timely Receipt of Treatment and Survival Among Patients With HR-Negative, HER2-Positive Breast Cancer.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Article
- Improved Diabetic Foot Ulcer Outcomes in Medicaid Beneficiaries with Podiatric Care Access.Diabetology · 2024Article
- Impact of Medicaid expansion under the Patient Protection and Affordable Care Act on lung cancer care in the US.Journal of thoracic disease · 2024Article
- Medicaid Expansion Under the Affordable Care Act and Early Mortality Following Lung Cancer Surgery.JAMA network open · 2024Article
- Disparities in anterior cervical discectomy and fusion provision and outcomes for cervical stenosis.North American Spine Society journal · 2023Article
- High-quality nursing service system is superior to routine care in the care management of malignancies.American journal of translational research · 2023Article
- Did Medicaid expansion close African American-white health care disparities nationwide? A scoping review.BMC public health · 2022Article
- Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum.Autism research : official journal of the International Society for Autism Research · 2022Article
- Article
- Changes in Cancer Mortality by Race and Ethnicity Following the Implementation of the Affordable Care Act in California.Frontiers in oncology · 2022Article
- Targets for improving disparate head and neck cancer outcomes in the low-income population.Laryngoscope investigative otolaryngology · 2021Review
- Race, Age, Gender, and Insurance Status: A Comparative Analysis of Access to and Quality of Gastrointestinal Cancer Care.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Association Between Medicaid Expansion and Diagnosis and Management of Colon Cancer.Journal of the American College of Surgeons · 2021Article
- High-quality nursing intervention can improve negative emotions, quality of life and activity of daily living of elderly patients with Parkinson's disease.American journal of translational research · 2021Article
- Effect of high-quality nursing intervention on psychological emotion, life quality and nursing satisfaction of patients with nasopharyngeal carcinoma undergoing radiotherapy.American journal of translational research · 2021Article
- Medicaid Expansion and Mortality Among Patients With Breast, Lung, and Colorectal Cancer.JAMA network open · 2020Observational
- Mortality-to-incidence ratios by US Congressional District: Implications for epidemiologic, dissemination and implementation research, and public health policy.Preventive medicine · 2019Article
- Correlation Between the Increased Hospital Volume and Decreased Overall Perioperative Mortality in One Universal Health Care System.World journal of surgery · 2019Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe Affordable Care Act's Medicaid expansion has been heavily debated due to skepticism about Medicaid's ability to provide high-quality care. Particularly, little is known about whether Medicaid expansion improves access to surgical cancer care at high-quality hospitals. To address this question, we examined the effects of the 2001 New York Medicaid expansion, the largest in the pre-Affordable Care Act era, on this disparity measure. STUDY
designWe identified 67,685 nonelderly adults from the New York State Inpatient Database who underwent select cancer resections. High-quality hospitals were defined as high-volume or low-mortality hospitals. Disparity was defined as model-adjusted difference in percentage of patients receiving operations at high-quality hospitals by insurance type (Medicaid/uninsured vs privately insured) or by race (African American vs white). Levels of disparity were calculated quarterly for each comparison pair and then analyzed using interrupted time series to evaluate the impact of Medicaid expansion.
resultsDisparity in access to high-volume hospitals by insurance type was reduced by 0.97 percentage points per quarter after Medicaid expansion (p < 0.0001). Medicaid/uninsured beneficiaries had similar access to low-mortality hospitals as the privately insured; no significant change was detected around expansion. Conversely, racial disparity increased by 0.87 percentage points per quarter (p < 0.0001) in access to high-volume hospitals and by 0.48 percentage points per quarter (p = 0.005) in access to low-mortality hospitals after Medicaid expansion.
conclusionsPre-Affordable Care Act Medicaid expansion reduced the disparity in access to surgical cancer care at high-volume hospitals by payer. However, it was associated with increased racial disparity in access to high-quality hospitals. Addressing racial barriers in access to high-quality hospitals should be prioritized.
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