Evidence map›Paper›PMID 39575430›Full record

ArticleFrontiers in oncology2024

Comparative impact of the affordable care act on breast cancer outcomes among women in two US states.

Oluwasegun Akinyemi, Mojisola Fasokun, Terhas Weldeslase, Eunice Odusanya, Irene Akinyemi, Kailyn Geter, Meghana Akula, Miriam Michael, Kakra Hughes, Robin Williams

Abstract read
In one paragraph

Article in Frontiers in oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

10 authors.

Oluwasegun AkinyemiCollege of Medicine, Howard University, Washington, DC, United States.
Mojisola FasokunDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States.
Terhas WeldeslaseCollege of Medicine, Howard University, Washington, DC, United States.
Eunice OdusanyaCollege of Medicine, Howard University, Washington, DC, United States.
Irene AkinyemiSchool of Nursing, Spoon River College, Canton, IL, United States.
Kailyn GeterCollege of Medicine, Howard University, Washington, DC, United States.
Meghana AkulaCollege of Medicine, Howard University, Washington, DC, United States.
Miriam MichaelCollege of Medicine, Howard University, Washington, DC, United States.
Kakra HughesCollege of Medicine, Howard University, Washington, DC, United States.
Robin WilliamsCollege of Medicine, Howard University, Washington, DC, United States.

Funding

Sleep Disorders in Adults with Sickle Cell Disease: Frequency, Associations with Cardiovascular and Pain Indicators, and Responses to TreatmentU54MD007597 · NIMHD · HOWARD UNIVERSITY · PI BYRON D. FORD · 2019 to 2026
$37.7M
NIMHD NIH HHS U54 MD007597
6 · The paper itself

Abstract

Introduction: Since the implementation of the Patient Protection and Affordable Care Act (ACA) and Medicaid expansion, states that adopted the policy have seen reduced uninsured rates. However, it is unclear whether increased healthcare access, particularly for minority and socioeconomically disadvantaged groups, has translated into measurable improvements in health outcomes. Objective: Our study aims to evaluate the impact of the ACA and Medicaid expansion on breast cancer outcomes in Louisiana, which has implemented the policy, compared to Georgia, which has not, as of 2024. Methodology: We conducted a retrospective study using SEER registry data from January 2011 to December 2021, including women aged 18-64 diagnosed with breast cancer. The impact of the ACA and Medicaid expansion on cancer-specific survival (CSS), overall survival (OS), and stage at presentation was evaluated. The cohort was divided into pre-ACA (2011-2015) and post-ACA (2017-2021) periods, with a one-year washout (2016). A difference-in-difference (DID) approach compared outcomes between Louisiana and Georgia. Results: The study analyzed 62,381 women with breast cancer, with 32,220 cases in the pre-ACA period (51.7%) and 30,161 in the post-ACA period (48.3%). In Georgia, 43,279 women were included (52.3% pre-ACA vs. 47.7% post-ACA), while Louisiana had 19,102 women (50.1% pre-ACA vs. 49.9% post-ACA). Medicaid expansion in Louisiana was associated with a 0.26 percentage point reduction in overall deaths (95% CI: -10.9 to 10.4) and a 5.97 percentage point reduction in cancer-specific mortality (95% CI: -26.1 to 14.2). There was also no significant difference in disease stage at presentation compared to Georgia. Conclusion: This study found no significant differences in overall mortality, cancer-specific mortality, or disease stage at presentation among women with breast cancer in Louisiana, which implemented Medicaid expansion in 2016, compared to Georgia, which has not expanded Medicaid.

Indexed as

affordable care actcancer-specific mortalitydifference - in – differencesGeorgiainverse probability of treatment weightingLouisianaMedicaid expansionoverall mortality

Identifiers

PMID39575430
PMCPMC11578952

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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.