학술논문
Causal Effects of the Affordable Care Act (ACA) Implementation on Non-Hodgkin's Lymphoma Survival: A Difference-in-Differences Analysis.
Document Type
Academic Journal
Author
Akinyemi OA; Health Policy and Management, University of Maryland School of Public Health, College Park, USA.; Surgery, Howard University, Washington DC, USA.; Weldeslase TA; Surgery, Howard University College of Medicine, Washington, USA.; Fasokun ME; Epidemiology and Public Health, University of Alabama at Birmingham, Birmingham, USA.; Odusanya E; Obstetrics and Gynecology, Howard University College of Medicine, Washington DC, USA.; Mejulu EO; Medical School, Western Illinois University, Illinois, USA.; Salihu EY; Department of Health Services Research, University of Wisconsin, Madison, USA.; Akueme NT; Dermatology, University of Medical Sciences (UNIMED), Ondo State, NGA.; Hughes K; Surgery, Howard University College of Medicine, Washington DC, USA.; Micheal M; Internal Medicine, Howard University College of Medicine, Washingon DC, USA.; Internal Medicine, University of Maryland School of Medicine, Baltimore, USA.
Source
Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2168-8184
Abstract
Introduction: Non-Hodgkin's Lymphoma (NHL) accounts for a substantial number of cancer cases in the United States, with a significant prevalence and mortality rate. The implementation of the Affordable Care Act (ACA) has the potential to impact cancer-specific survival among NHL patients by improving access to healthcare services and treatments.
Objective: This study aims to assess the impact of the implementation of the ACA on cancer-specific survival among patients diagnosed with NHL.
Methodology: In this retrospective analysis, we leveraged data from the Surveillance, Epidemiology, and End Results (SEER) registry to assess the impact of the ACA on cancer-specific survival among NHL patients. The study covered the years 2000-2020, divided into pre-ACA (2000-2013) and post-ACA (2017-2020) periods, with a three-year washout (2014-2016). Using a Difference-in-Differences approach, we compared Georgia (a non-expansion state) to New Jersey (an expansion state since 2014). We adjusted for patient demographics, income, metropolitan status, disease stage, and treatment modalities.
Results: Among 74,762 patients, 56.2% were in New Jersey (42,005), while 43.8% were in Georgia (32,757). The pre-ACA period included 32,851 patients (51.7% in Georgia and 56.7% in New Jersey), and 27,447 patients were in the post-ACA period (48.3% in Georgia and 43.4% in New Jersey). The post-ACA period exhibited a 34% survival improvement (OR=0.66, 95% CI 0.58-0.75). ACA implementation was associated with a 16% survival boost among NHL patients in New Jersey (OR=0.84, 95% CI 0.74-0.95). Other factors linked to improved survival included surgery (OR=0.86, 95% CI 0.81-0.91), radiotherapy (OR=0.77, 95% CI 0.72-0.82), and married status (OR=0.67, 95% CI 0.64-0.71).
Conclusion: The study underscores the ACA's potential positive impact on cancer-specific survival among NHL patients, emphasizing the importance of healthcare policy interventions in improving patient outcomes.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Akinyemi et al.)
Objective: This study aims to assess the impact of the implementation of the ACA on cancer-specific survival among patients diagnosed with NHL.
Methodology: In this retrospective analysis, we leveraged data from the Surveillance, Epidemiology, and End Results (SEER) registry to assess the impact of the ACA on cancer-specific survival among NHL patients. The study covered the years 2000-2020, divided into pre-ACA (2000-2013) and post-ACA (2017-2020) periods, with a three-year washout (2014-2016). Using a Difference-in-Differences approach, we compared Georgia (a non-expansion state) to New Jersey (an expansion state since 2014). We adjusted for patient demographics, income, metropolitan status, disease stage, and treatment modalities.
Results: Among 74,762 patients, 56.2% were in New Jersey (42,005), while 43.8% were in Georgia (32,757). The pre-ACA period included 32,851 patients (51.7% in Georgia and 56.7% in New Jersey), and 27,447 patients were in the post-ACA period (48.3% in Georgia and 43.4% in New Jersey). The post-ACA period exhibited a 34% survival improvement (OR=0.66, 95% CI 0.58-0.75). ACA implementation was associated with a 16% survival boost among NHL patients in New Jersey (OR=0.84, 95% CI 0.74-0.95). Other factors linked to improved survival included surgery (OR=0.86, 95% CI 0.81-0.91), radiotherapy (OR=0.77, 95% CI 0.72-0.82), and married status (OR=0.67, 95% CI 0.64-0.71).
Conclusion: The study underscores the ACA's potential positive impact on cancer-specific survival among NHL patients, emphasizing the importance of healthcare policy interventions in improving patient outcomes.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Akinyemi et al.)