Insurance status impacts treatment for hepatocellular carcinoma
Introduction and aim: Previous studies have identified treatment disparities in the treatment of hepatocellular carcinoma (HCC) based on insurance status and provider. Recent studies have shown more Americans have healthcare insurance; therefore we aim to determine if treatment disparities based on...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-05-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119300298 |
| _version_ | 1819101234611617792 |
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| author | Lindsay A. Sobotka Alice Hinton Lanla F. Conteh |
| author_facet | Lindsay A. Sobotka Alice Hinton Lanla F. Conteh |
| author_sort | Lindsay A. Sobotka |
| collection | DOAJ |
| description | Introduction and aim: Previous studies have identified treatment disparities in the treatment of hepatocellular carcinoma (HCC) based on insurance status and provider. Recent studies have shown more Americans have healthcare insurance; therefore we aim to determine if treatment disparities based on insurance providers continue to exist. Materials and methods: A retrospective database analysis using the NIS was performed between 2010 and 2013 including adult patients with a primary diagnosis of HCC determined by ICD-9 codes. Multivariable logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient's primary payer. Results: This study included 62,368 patients. Medicare represented 44% of the total patients followed by private insurance (27%), Medicaid (19%), and other payers (10%). Patients with Medicare, Medicaid, and other payer were less likely to undergo liver transplantation [(OR 0.63, 95% CI 0.47–0.84), (OR 0.23, 95% CI 0.15–0.33), (OR 0.26, 95% CI 0.15–0.45)] and surgical resection [(OR 0.74, 95% CI 0.63–0.87), (OR 0.40, 95% CI 0.32–0.51), (OR 0.42, 95% CI 0.32–0.54)] than patients with private insurance. Medicaid patients were less likely to undergo ablation then patients with private insurance (OR 0.52, 95% CI 0.40–0.68). Patients with other forms of insurance were less likely to undergo transarterial chemoembolization (TACE) compared to private insurance (OR 0.64, 95% CI 0.43–0.96). Conclusion: Insurance status impacts treatment for HCC. Patients with private insurance are more likely to undergo curative therapies of liver transplantation and surgical resection compared to patients with government funded insurance. |
| first_indexed | 2024-12-22T01:15:26Z |
| format | Article |
| id | doaj.art-1e126e6494894e6cb3691bf40de90e2d |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-22T01:15:26Z |
| publishDate | 2019-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-1e126e6494894e6cb3691bf40de90e2d2022-12-21T18:43:52ZengElsevierAnnals of Hepatology1665-26812019-05-01183461465Insurance status impacts treatment for hepatocellular carcinomaLindsay A. Sobotka0Alice Hinton1Lanla F. Conteh2Department of Internal Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United StatesDivision of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, United StatesDepartment of Medicine, Section of Gastroenterology, Hepatology and Nutrition, The Ohio State Wexner Medical Center, Columbus, Ohio, United States; Corresponding author at: 410W. 10th Street, Columbus, OH 43210, United States.Introduction and aim: Previous studies have identified treatment disparities in the treatment of hepatocellular carcinoma (HCC) based on insurance status and provider. Recent studies have shown more Americans have healthcare insurance; therefore we aim to determine if treatment disparities based on insurance providers continue to exist. Materials and methods: A retrospective database analysis using the NIS was performed between 2010 and 2013 including adult patients with a primary diagnosis of HCC determined by ICD-9 codes. Multivariable logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient's primary payer. Results: This study included 62,368 patients. Medicare represented 44% of the total patients followed by private insurance (27%), Medicaid (19%), and other payers (10%). Patients with Medicare, Medicaid, and other payer were less likely to undergo liver transplantation [(OR 0.63, 95% CI 0.47–0.84), (OR 0.23, 95% CI 0.15–0.33), (OR 0.26, 95% CI 0.15–0.45)] and surgical resection [(OR 0.74, 95% CI 0.63–0.87), (OR 0.40, 95% CI 0.32–0.51), (OR 0.42, 95% CI 0.32–0.54)] than patients with private insurance. Medicaid patients were less likely to undergo ablation then patients with private insurance (OR 0.52, 95% CI 0.40–0.68). Patients with other forms of insurance were less likely to undergo transarterial chemoembolization (TACE) compared to private insurance (OR 0.64, 95% CI 0.43–0.96). Conclusion: Insurance status impacts treatment for HCC. Patients with private insurance are more likely to undergo curative therapies of liver transplantation and surgical resection compared to patients with government funded insurance.http://www.sciencedirect.com/science/article/pii/S1665268119300298MedicaidMedicarePrivate insuranceLiver transplantationDisparities |
| spellingShingle | Lindsay A. Sobotka Alice Hinton Lanla F. Conteh Insurance status impacts treatment for hepatocellular carcinoma Annals of Hepatology Medicaid Medicare Private insurance Liver transplantation Disparities |
| title | Insurance status impacts treatment for hepatocellular carcinoma |
| title_full | Insurance status impacts treatment for hepatocellular carcinoma |
| title_fullStr | Insurance status impacts treatment for hepatocellular carcinoma |
| title_full_unstemmed | Insurance status impacts treatment for hepatocellular carcinoma |
| title_short | Insurance status impacts treatment for hepatocellular carcinoma |
| title_sort | insurance status impacts treatment for hepatocellular carcinoma |
| topic | Medicaid Medicare Private insurance Liver transplantation Disparities |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119300298 |
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