Association of insurance types and outcomes in acute promyelocytic leukemia.
Prajwal DhakalUtsav JoshiElizabeth LydenAvantika PyakuryalKrishna GundaboluVijaya Raj BhattPublished in: Leukemia & lymphoma (2022)
Understanding the association between insurance status and survival in an evolving US healthcare system remains a challenge but is essential to address healthcare disparities. We utilized National Cancer Database to evaluate the effects of insurance type on one-month mortality and overall survival (OS) in patients with acute promyelocytic leukemia. Among patients <65 years, one-month mortality was worse for uninsured patients and patients with Medicare compared to patients with private insurance. OS was similar between patients with private insurance and uninsured patients but worse for patients with Medicare and Medicaid/other government insurance. In multivariate analysis, older age and greater comorbidity burden conferred worse OS. For patients ≥65 years, insurance type did not affect one-month mortality and OS. Older age, greater comorbidity burden, and treatment at non-academic centers conferred worse one-month mortality and OS. Our results highlight healthcare disparities based on insurance types for both younger and older patients.
Keyphrases
- affordable care act
- health insurance
- healthcare
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- risk factors
- prognostic factors
- emergency department
- physical activity
- type diabetes
- coronary artery disease
- patient reported outcomes
- adipose tissue
- acute myeloid leukemia
- intensive care unit
- bone marrow
- social media
- adverse drug