Impact of Medicaid Expansion on Survival in Lower Gastrointestinal Cancer Patients
Author Information
Author(s): Ramalingam Kirithiga MD, Ji Liang MPH, O’Leary Michael P. MD, Lum Sharon S. MD, MBA, Caba Molina David MD, MS, MPH
Primary Institution: Loma Linda University
Hypothesis
Medicaid expansion is associated with decreased all-cause mortality of lower gastrointestinal cancer patients following CRS+HIPEC.
Conclusion
Improved access to healthcare through Medicaid expansion was associated with increased survival rates of lower gastrointestinal cancer patients who undergo CRS+HIPEC.
Supporting Evidence
- Patients in Medicaid expansion states experienced a 4% increase in annual survival.
- Patients in non-expansion states had a 1% decrease in annual survival.
- Grade and Medicaid expansion status were independently associated with overall survival.
Takeaway
This study found that patients in states that expanded Medicaid had better chances of living longer after surgery for cancer in their lower intestines.
Methodology
Data from the National Cancer Database (2010–2019) was analyzed using a multivariable Cox regression model.
Potential Biases
Incomplete data and loss of follow-up could introduce bias.
Limitations
The study relies on overall survival as the primary outcome measure and may not be generalizable to patients treated outside Commission on Cancer-accredited programs.
Participant Demographics
75.8% of patients were younger than 65 years, predominantly non-Hispanic White (81.7%).
Statistical Information
P-Value
p<0.001
Confidence Interval
0.52–0.97
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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