ArticleAnnals of surgical oncology2025
The Real Safety Net Hospitals: High-Medicaid Hospitals Confer Worse Survival for Patients Undergoing Pancreas and Biliary Cancer Surgery.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundLarge-database cancer research often defines hospitals servicing a threshold number of Medicaid patients "safety net"; however, counts are generally with the cancer of interest, and because sufficient rare/complex cases such as hepatobiliary/pancreatic (HPB) cancers tend to be managed at larger institutions, "safety net" may be skewed toward academic centers. Recent data show similar survival for "safety net" HPB care. We examine patterns/outcomes of curative intent surgery (CIS) for HPB cancers by a more comprehensive Medicaid-serving (AID) status utilizing all alimentary tract cancers to generate AID quartiles. PATIENTS AND
methodsWe identified all alimentary tract cancers (NCDB: 2004-2021) to determine quartile proportions of Medicaid-insured patients. Stage I-III primary HPB cancers were analyzed by highest quartile of AID facility ("high-AID") versus remaining quartiles ("low-AID"). Logistic regression identified predictors for undergoing CIS. Cox proportional regression modeled survival. P < 0.01 was significant.
resultsHPB cancer cases totaled 286,873. High-AID patients were more likely to be non-white and have low income/education. Patients were less likely to undergo CIS at high-AID programs (hepatic [H]: OR 0.83, 95% CI 0.80-0.86; pancreas [P]: OR 0.81, 95% CI 0.78-0.84; biliary [B]: OR 0.83, 95% CI 0.79-0.87). Multivariable analyses showed similar survival at 1 and 5 years for hepatic resection at high-AID facilities (1 year: HR 1.01 [0.89-1.14]; 5 years: HR 1.01 [0.95-1.07]). High-AID for pancreatic/biliary patients had greater mortality risk at 1 and 5 years.
conclusionsIncluding more hospitals to define AID status revealed worse survival at high-Medicaid-serving facilities for pancreatic/biliary, but not hepatic cancer surgery patients. Our "safety net hospital" proxy (high-AID) allows for better care disparity identification for complex underserved patients with cancer.
Identifiers
What OpenQuestion holds
Registered trials
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.