The biggest difference between the two groups was in patients whose cancers hadn't reached a metastatic stage and are considered curable. When investigators adjusted for the stage at which cancers were diagnosed, improvements in mortality were no longer seen - whether between expansion and non-expansion states or between the pre-expansion and post-expansion period. This suggests that the decline in mortality associated with Medicaid expansion is a byproduct of diagnosing cancer at an earlier stage.
"Increased Medicaid coverage may remove barriers to accessing the healthcare system for screening and timely symptom evaluation, and that can translate into better outcomes for patients," Lam comments.
The investigators also found that the decrease in mortality in Medicaid-expansion states occurred across population groups. "We were reassured to find that patients living in areas of the lowest quartile of median household income showed a modest decrease in mortality after Medicaid expansion," Lam observes. "We also found that the mortality improvements occurred in both Black and white populations."
The senior author of the study was Nancy Keating, MD, MPH, of Brigham and Women's and Harvard Medical School. Co-authors are Jessica Phelan, MS, and Ashish Jha, MD, MPH, of Harvard T.H. Chan School of Public Health; and John Orav, PhD, of Brigham and Women's and Harvard T.H. Chan School of Public Health.
The study was conducted with the support of a KL2 award from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health Award KL2 TR002542).
About Dana-Farber Cancer Institute
Dana-Farber Cancer Institute is one of the world's leading centers of cancer research and treatment. Dana-Farber's mission is to reduce the burden of cancer through scientific inquiry, clinical care, education, community engagement, and advocacy. We provide the latest treatments in cancer for adults through Dana-Farber/Brigham and Women's Cancer Center and for children through Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Dana-Farber is the only hospital nationwide with a top 10 U.S. News & World Report Best Cancer Hospital ranking in both adult and pediatric care.
As a global leader in oncology, Dana-Farber is dedicated to a unique and equal balance between cancer research and care, translating the results of discovery into new treatments for patients locally and around the world, offering more than 1,100 clinical trials.
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