학술논문

Treatment quality and outcomes vary with hospital burden of uninsured and Medicaid patients with cancer in early non–small cell lung cancerCentral MessagePerspective
Document Type
article
Source
JTCVS Open, Vol 11, Iss , Pp 272-285 (2022)
Subject
disparities
lung cancer
Medicaid
quality measures
safety-net
uninsured
Diseases of the circulatory (Cardiovascular) system
RC666-701
Surgery
RD1-811
Language
English
ISSN
2666-2736
Abstract
Objectives: Safety-net hospitals deliver a significant level of care to uninsured patients, Medicaid-enrolled patients, and other vulnerable patients. Little is known about the impact of safety-net hospital status on outcomes in non–small cell lung cancer. We aimed to compare treatment characteristics and outcomes between hospitals categorized according to their relative burden of uninsured or Medicaid-enrolled patients with non–small cell lung cancer. Methods: We queried the National Cancer Database for patients with clinical stage I and II non–small cell lung cancer presenting from 2004 to 2018. We categorized hospitals on the basis of their relative burden of uninsured or Medicaid-enrolled patients with non–small cell lung cancer into low-burden (16.8%) quartiles. We investigated the impact of care at these hospitals on outcomes while controlling for sociodemographic, clinical, and facility characteristics. Results: We identified 204,189 patients treated at 1286 facilities. There were 592 low-burden, 297 medium-burden, 219 high-burden, and 178 highest burden hospitals. Patients at highest burden hospitals were more likely to be younger, male, Black, and Hispanic (P