Hodgkin Lymphoma Outcomes Worse In Medicaid, Uninsured Patients

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.

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).

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.

Reference

1. Parikh RR, Grossbard ML, Green BL, et al. Disparities in survival by insurance status in patients with Hodgkin lymphoma. Cancer. 2015. [Epub ahead of print]. doi: 10.1002/cncr.29518.