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Meera Ragavan
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P09 - Health Services Research/Health Economics - Real World Outcomes (ID 121)
- Event: WCLC 2020
- Type: Posters
- Track: Health Services Research/Health Economics
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P09.36 - Impact of Medicaid Enrollment on Mortality in Elderly Dual-Eligible Lung Cancer Patients (ID 3017)
00:00 - 00:00 | Presenting Author(s): Meera Ragavan
- Abstract
Introduction
Dual-eligible (DE) patients are insured by both Medicaid and Medicare and are known to have complex medical needs. DE cancer patients are less likely to undergo definitive surgical resection of early stage disease and more likely to experience treatment delays, but also benefit from lower copays compared to patients with Medicare alone (non-DE). Lung cancer (LC) is the most common cancer diagnosed in the DE population, but little is known about the outcomes of DE patients with LC. Our study sought to assess the impact of DE status on overall survival in LC patients.
Methods
We conducted a retrospective longitudinal analysis of survival data for Medicare patients diagnosed with LC, extracted from the Medicare-SEER database. Patients were defined as “DE” if they were designated as DE status during the month of diagnosis. Cox regression analysis was performed to evaluate the association between mortality and DE, adjusting for age, gender, race, stage at diagnosis, histology, place of residence (urban vs. rural), Federal Income Processing Standard (FIPS) median household income, and Charlson comorbidity index (CCI). The association between mortality and DE was further stratified by race, income, and stage.
Results
Out of 113,162 patients included in the analysis, 21,236(19%) were DE. DE patients had an increased risk of overall mortality compared to non-DE patients (HR 1.20,95% CI: 1.17-1.22,p<0.001) in the adjusted model. (Figure 1) The impact of DE status on mortality varied by race, stage, and income (Table 1).
Conclusion
DE status was associated with a higher risk of mortality overall, although this varied by race. The strength of this association was higher for patients diagnosed at an earlier stage and with a lower FIPS median household income. Future studies should explore the factors that influence this survival differential and consider targeted interventions at the policy level to improve outcomes in DE patients.
