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Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act
Despite advances toward universal health insurance coverage for children, coverage gaps remain. Using a nationwide sample of pediatric and adolescent cancer patients from the National Cancer Database, we examined effects of the Affordable Care Act (ACA) implementation in 2014 with multinomial logist...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8877169/ https://www.ncbi.nlm.nih.gov/pubmed/35699500 http://dx.doi.org/10.1093/jncics/pkac006 |
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author | Ji, Xu Hu, Xin Castellino, Sharon M Mertens, Ann C Yabroff, K Robin Han, Xuesong |
author_facet | Ji, Xu Hu, Xin Castellino, Sharon M Mertens, Ann C Yabroff, K Robin Han, Xuesong |
author_sort | Ji, Xu |
collection | PubMed |
description | Despite advances toward universal health insurance coverage for children, coverage gaps remain. Using a nationwide sample of pediatric and adolescent cancer patients from the National Cancer Database, we examined effects of the Affordable Care Act (ACA) implementation in 2014 with multinomial logistic regressions to evaluate insurance changes between 2010-2013 (pre-ACA) and 2014-2017 (post-ACA) in patients aged younger than 18 years (n = 63 377). All statistical tests were 2-sided. Following the ACA, the overall percentage of Medicaid and Children’s Health Insurance Program–covered patients increased (from 35.1% to 36.9%; adjusted absolute percentage change [APC] = 2.01 percentage points [ppt], 95% confidence interval [CI] = 1.31 to 2.71; P < .001), partly offset by declined percentage of privately insured (from 62.7% to 61.2%; adjusted APC = −1.67 ppt, 95% CI = −2.37 to −0.97; P < .001), leading to a reduction by 15% in uninsured status (from 2.2% to 1.9%; adjusted APC = −0.34 ppt, 95% CI = −0.56 [Formula: see text] −0.12 ppt; P = .003). The largest declines in uninsured status were observed among Hispanic patients (by 23%; adjusted APC = −0.95 ppt, 95% CI = −1.67 [Formula: see text] −0.23 ppt; P = .009) and patients residing in low-income areas (by 35%; adjusted APC = −1.22 ppt, 95% CI = −2.22 [Formula: see text] −0.21 ppt; P = .02). We showed nationwide insurance gains among pediatric and adolescent cancer patients following ACA implementation, with greater gains in racial and ethnic minorities and those living in low-income areas. |
format | Online Article Text |
id | pubmed-8877169 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-88771692022-02-28 Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act Ji, Xu Hu, Xin Castellino, Sharon M Mertens, Ann C Yabroff, K Robin Han, Xuesong JNCI Cancer Spectr Brief Communications Despite advances toward universal health insurance coverage for children, coverage gaps remain. Using a nationwide sample of pediatric and adolescent cancer patients from the National Cancer Database, we examined effects of the Affordable Care Act (ACA) implementation in 2014 with multinomial logistic regressions to evaluate insurance changes between 2010-2013 (pre-ACA) and 2014-2017 (post-ACA) in patients aged younger than 18 years (n = 63 377). All statistical tests were 2-sided. Following the ACA, the overall percentage of Medicaid and Children’s Health Insurance Program–covered patients increased (from 35.1% to 36.9%; adjusted absolute percentage change [APC] = 2.01 percentage points [ppt], 95% confidence interval [CI] = 1.31 to 2.71; P < .001), partly offset by declined percentage of privately insured (from 62.7% to 61.2%; adjusted APC = −1.67 ppt, 95% CI = −2.37 to −0.97; P < .001), leading to a reduction by 15% in uninsured status (from 2.2% to 1.9%; adjusted APC = −0.34 ppt, 95% CI = −0.56 [Formula: see text] −0.12 ppt; P = .003). The largest declines in uninsured status were observed among Hispanic patients (by 23%; adjusted APC = −0.95 ppt, 95% CI = −1.67 [Formula: see text] −0.23 ppt; P = .009) and patients residing in low-income areas (by 35%; adjusted APC = −1.22 ppt, 95% CI = −2.22 [Formula: see text] −0.21 ppt; P = .02). We showed nationwide insurance gains among pediatric and adolescent cancer patients following ACA implementation, with greater gains in racial and ethnic minorities and those living in low-income areas. Oxford University Press 2022-02-04 /pmc/articles/PMC8877169/ /pubmed/35699500 http://dx.doi.org/10.1093/jncics/pkac006 Text en © The Author(s) 2022. Published by Oxford University Press. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Brief Communications Ji, Xu Hu, Xin Castellino, Sharon M Mertens, Ann C Yabroff, K Robin Han, Xuesong Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act |
title | Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act |
title_full | Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act |
title_fullStr | Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act |
title_full_unstemmed | Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act |
title_short | Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act |
title_sort | narrowing insurance disparities among children and adolescents with cancer following the affordable care act |
topic | Brief Communications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8877169/ https://www.ncbi.nlm.nih.gov/pubmed/35699500 http://dx.doi.org/10.1093/jncics/pkac006 |
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