Evidence map›Paper›PMID 35213464›Full record

ArticleJournal of the American College of Surgeons2022

Impact of Medicaid Expansion on Pancreatic Cancer: An Examination of Sociodemographic Disparity in 1-Year Survival.

Erin M Mobley, Ian Tfirn, Christina Guerrier, Michael S Gutter, Kim Vigal, Keouna Pather, Brett Baskovich, Ziad T Awad, Alexander S Parker

Abstract read
In one paragraph

Article in Journal of the American College of Surgeons, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Impact of Medicaid Expansion on the Treatment and Outcomes of Intrahepatic Cholangiocarcinoma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023
    Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Erin M MobleyFrom the Department of Surgery (Mobley, Pather, Awad), University of Florida, Jacksonville, FL.
Ian TfirnCenter for Data Solutions (Tfirn, Guerrier, Vigal), University of Florida, Jacksonville, FL.
Christina GuerrierCenter for Data Solutions (Tfirn, Guerrier, Vigal), University of Florida, Jacksonville, FL.
Michael S GutterInstitute for Food and Agricultural Sciences (Gutter), University of Florida, Gainesville, FL.
Kim VigalCenter for Data Solutions (Tfirn, Guerrier, Vigal), University of Florida, Jacksonville, FL.
Keouna PatherFrom the Department of Surgery (Mobley, Pather, Awad), University of Florida, Jacksonville, FL.
Brett BaskovichDepartment of Pathology (Baskovich), University of Florida, Jacksonville, FL.
Ziad T AwadFrom the Department of Surgery (Mobley, Pather, Awad), University of Florida, Jacksonville, FL.
Alexander S ParkerCollege of Medicine (Parker), University of Florida, Jacksonville, FL.

Funding

The University of Florida Jacksonville Aging Studies Center (JAX-ASCENT)R33AG056540 · NIA · UNIVERSITY OF FLORIDA · PI ANTON, STEPHEN D · 2017 to 2021
$3.8M
NCI NIH HHS L40 CA253827NIA NIH HHS R33 AG056540
6 · The paper itself

Abstract

backgroundThis study examined the effect of Medicaid expansion on 1-year survival of pancreatic cancer for nonelderly adults. We further evaluated whether sociodemographic and county characteristics alter the association of Medicaid expansion and 1-year survival. STUDY

designWe obtained data from the Surveillance Epidemiology and End-Results dataset on individuals diagnosed with pancreatic cancer from 2007 to 2015. A Difference-in-Differences model compared those from early-adopting states to non-early-adopting states, before and after adoption (2014), while taking into consideration sociodemographic and county characteristics to estimate the effect of Medicaid expansion on 1-year survival.

resultsIn the univariable Difference-in-Differences model, the probability of 1-year survival for pancreatic cancer increased by 4.8 percentage points (ppt) for those from Medicaid expansion states postexpansion (n = 35,347). After adjustment for covariates, the probability of 1-year survival was reduced to 0.8 ppt. Interestingly, after multivariable adjustment the effect of living in an expansion state on 1-year survival was similar for men and women (0.6 ppt for men vs 1.2 ppt for women), was also similar for Whites (2.6 ppt), and was higher in those of other races (5.9 ppt) but decreased for Blacks (-2.0 ppt). Those who were insured (-0.1 ppt) or uninsured (-2.2 ppt) experienced a decrease in the probability of 1-year survival; however, those who were covered by Medicaid at diagnosis experienced an increase in the probability of 1-year survival (7.4 ppt).

conclusionsMedicaid expansion during or after 2014 is associated with an increase in the probability of 1-year survival for pancreatic cancer; however, this effect is attenuated after adjustment for sociodemographic characteristics. Of note, the positive association was more pronounced in certain categories of key covariates suggesting further inquiry focused on these subgroups.

Indexed as

MedicaidPancreatic NeoplasmsAdultFemaleHumansInsurance CoverageMaleMedically UninsuredPatient Protection and Affordable Care ActUnited StatesWhite People

Identifiers

PMID35213464
PMCPMC9132328

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Registered trials

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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.