Patients with Hodgkin lymphoma who have Medicaid or are uninsured have outcomes inferior to those of patients with more favorable insurance, a recent study published online ahead of print in the journal Cancer has shown.
For the study, researchers sought to investigate disparities in overall survival by insurance status in a large population of patients with Hodgkin lymphoma.
Researchers analyzed the data from 45,777 patients with stage I to IV Hodgkin lymphoma from the National Cancer Data Base. Of those, 7.1% were uninsured, 17% had Medicaid, 66.3% had private insurance, 8.2% had managed care, and 1.1% had Medicare.
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Results showed that patients with Medicaid or who were uninsured were at a more advanced stage, had higher comorbidity scores, had B symptoms, and were in a lower education/income quartile (all P<0.01).
Researchers found that these patients with unfavorable insurance status were less likely to receive radiotherapy and start chemotherapy quickly. They were also less often treated at an academic/research institution (all P<0.01).
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Five-year overall survival rates were 54% for patients with unfavorable insurance status compared with 87% for those with favorable insurance (P<0.01). Unfavorable insurance status was significantly associated with substantially reduced overall survival (HR = 1.60; 95% CI: 1.34, 1.91; P<0.01).
The findings suggest that targeting those patients with unfavorable insurance status and limited access to care may improve clinical outcomes.
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