ArticleJournal of surgical oncology2021
Medicaid expansion and the management of pancreatic cancer.
Article in Journal of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 24 citations in OpenAlex.
- Review
- Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured.Cancer medicine · 2024Article
- Medicaid Expansion Increases Access for Rural and Impoverished Patients with Pancreatic Ductal Adenocarcinoma in Southern States.Annals of surgical oncology · 2024Article
- Affordable Care Act Medicaid Expansion Association with Improved Cancer Outcomes: Quality at What Cost?Annals of surgical oncology · 2023Article
- Impact of Medicaid Expansion on Abdominal Surgery Morbidity, Mortality, and Hospital Readmission.The Journal of surgical research · 2023Article
- The Impact of Medicaid Expansion on Early-Stage Pancreatic Adenocarcinoma at High- Versus Low-Volume Facilities.Annals of surgical oncology · 2023Article
- The Impact of Medicaid Expansion on Early-Stage Hepatocellular Carcinoma Care.Annals of surgical oncology · 2023Article
- Improving Survival with Medicaid Expansion in Early Hepatocellular Carcinoma: A Step in the Right Direction.Annals of surgical oncology · 2023Article
- The Impact of Medicaid Expansion on Patients with Cancer in the United States: A Review.Current oncology (Toronto, Ont.) · 2023Review
- Medicaid expansion and surgery for HPB/GI cancers: NCDB difference-in-difference analysis.American journal of surgery · 2023Article
- Palliative Therapies in Metastatic Pancreatic Cancer: Does Medicaid Expansion Make a Difference?Annals of surgical oncology · 2023Article
- Impact of Medicaid Expansion on Pancreatic Cancer: An Examination of Sociodemographic Disparity in 1-Year Survival.Journal of the American College of Surgeons · 2022Article
- Article
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundMedicaid expansion under the Affordable Care Act has improved access to screening and treatment for certain cancers. It is unclear how this policy has affected the diagnosis and management of pancreatic cancer.
methodsUsing a quasi-experimental difference-in-differences (DID) approach, we analyzed Medicaid and uninsured patients in the National Cancer Data Base during two time periods: pre-expansion (2011-2012) and postexpansion (2015-2016). We investigated changes in cancer staging, treatment decisions, and surgical outcomes.
resultsIn this national cohort, pancreatic cancer patients in expansion states had increased Medicaid coverage relative to those in nonexpansion states (DID = 17.49, p < 0.01). Medicaid expansion also led to an increase in early-stage diagnoses (Stage I/II, DID = 4.71, p = 0.03), higher comorbidity scores among surgical patients (Charlson/Deyo score 0: DID = -13.69, p = 0.02), a trend toward more neoadjuvant radiation (DID = 6.15, p = 0.06), and more positive margins (DID = 11.69, p = 0.02). There were no differences in rates of surgery, postoperative outcomes, or overall survival.
conclusionMedicaid expansion was associated with improved insurance coverage and earlier stage diagnoses for Medicaid and uninsured pancreatic cancer patients, but similar surgical outcomes and overall survival. These findings highlight both the benefits of Medicaid expansion and the potential limitations of policy change to improve outcomes for such an aggressive malignancy.
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