Evidence map›Paper›PMID 38698670›Full record

ArticleHealth services research2024

Impact of the Affordable Care Act on access to accredited facilities for cancer treatment.

Lindsay M Sabik, Youngmin Kwon, Coleman Drake, Jonathan Yabes, Manisha Bhattacharya, Zhaojun Sun, Cathy J Bradley, Bruce L Jacobs

Abstract read
In one paragraph

Article in Health services research, 2024. 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. Article
  3. 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

8 authors.

Lindsay M SabikUniversity of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-0613-4929
Youngmin KwonUniversity of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.ORCID 0000-0001-8037-5758
Coleman DrakeUniversity of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-0618-0626
Jonathan YabesUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-9406-2362
Manisha BhattacharyaUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Zhaojun SunUniversity of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-0931-4044
Cathy J BradleyColorado School of Public Health and University of Colorado Cancer Center, Aurora, Colorado, USA.ORCID 0000-0001-9429-6567
Bruce L JacobsUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.ORCID 0000-0003-1358-0764

Funding

Effects of Insurance Expansions on Cancer Treatment: Recent Policy Changes and Implications for Future ReformR01HS027396 · AHRQ · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SABIK, LINDSAY MARIE · 2020 to 2023
$1.5M
AHRQ HHS R01 HS027396AHRQ HHS R01HS027396
6 · The paper itself

Abstract

objectiveTo examine differential changes in receipt of surgery at National Cancer Institute (NCI)-designated comprehensive cancer centers (NCI-CCC) and Commission on Cancer (CoC) accredited hospitals for patients with cancer more likely to be newly eligible for coverage under Affordable Care Act (ACA) insurance expansions, relative to those less likely to have been impacted by the ACA. DATA SOURCES AND STUDY

settingPennsylvania Cancer Registry (PCR) for 2010-2019 linked with discharge records from the Pennsylvania Health Care Cost Containment Council (PHC4). STUDY

designOutcomes include whether cancer surgery was performed at an NCI-CCC or a CoC-accredited hospital. We conducted a difference-in-differences analysis, estimating linear probability models for each outcome that control for residence in a county with above median county-level pre-ACA uninsurance and the interaction between county-level baseline uninsurance and cancer treatment post-ACA to capture differential changes in access between those more and less likely to become newly eligible for insurance coverage (based on area-level proxy). All models control for age, sex, race and ethnicity, cancer site and stage, census-tract level urban/rural residence, Area Deprivation Index, and year- and county-fixed effects. DATA COLLECTION/EXTRACTION

methodsWe identified adults aged 26-64 in PCR with prostate, lung, or colorectal cancer who received cancer-directed surgery and had a corresponding surgery discharge record in PHC4. PRINCIPAL

findingsWe observe a differential increase in receiving care at an NCI-CCC of 6.2 percentage points (95% CI: 2.6-9.8; baseline mean = 9.8%) among patients in high baseline uninsurance areas (p = 0.001). Our estimate of the differential change in care at the larger set of CoC hospitals is positive (3.9 percentage points [95% CI: -0.5-8.2; baseline mean = 73.7%]) but not statistically significant (p = 0.079).

conclusionsOur findings suggest that insurance expansions under the ACA were associated with increased access to NCI-CCCs.

Indexed as

Cancer Care FacilitiesHealth Services AccessibilityInsurance CoverageNeoplasmsPatient Protection and Affordable Care ActAdultFemaleHumansMaleMiddle AgedPennsylvaniaUnited Statesaccess/demand/utilization of servicesgeographic/spatial factors/small area variationshealth care disparitiesMedicaidMedicaresurgery

Identifiers

PMID38698670
PMCPMC11622264

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.