Many studies attempt to answer the question: do African-Americans have poorer cancer survival and late stage cancer presentation once socioeconomic status is adequately controlled? Even though these studies vary in design, richness of data, and study and control populations, this research question remains unresolved. Explanatory variables used to date can be classified into three categories: socioeconomic status, insurance status, and treatment aggressiveness. Our study brings together a rich data set to analyze cancer diagnosis, treatment, and outcomes for patients insured by Medicaid. We identify incident cancer cases in 1996 and 1997 in Michigan. We then match these cases against the Medicaid eligibility file and death certificates. For patients who are Medicaid eligible, we extract their medical claim files. The analyses focused on breast cervical, colon, lung and prostate cancers Our primary outcomes of interest are: stage at diagnosis, survival, and receipt of state-of-the art treatment. We use logistic regression to estimate the probability of late stage diagnosis and death and show of that both of theses outcomes is greater among those insured by Medicaid compared to a non Medicaid control group. African-Americans are also more likely to be diagnosed at a later stage and to have poorer survival. In an analysis of claims data, we determine if the Medicaid study group receive state-of-art treatment for their cancers. Within the study group, we explore treatment differences by race and gender. The results of our study lend further insight into why patients who are insured by Medicaid have poorer cancer outcomes.
Learning Objectives: 1. List key contributors to late stage diagnosis and poor survival among a Medicaid cancer population. 2. Discuss the appropriateness of cancer care given to a Medicaid population. 3. Discuss racial differences in care provided to a Medicaid population
Keywords: Cancer, Access and Services
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.