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Effects of Type of Health Insurance Coverage on Colorectal Cancer Survival in Puerto Rico: A Population-Based Study

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  • Karen J Ortiz-Ortiz
  • Roberto Ramírez-García
  • Marcia Cruz-Correa
  • Moraima Y Ríos-González
  • Ana Patricia Ortiz

Abstract

Colorectal cancer represents a major health problem and an important economic burden in Puerto Rico. In the 1990's, the Commonwealth of Puerto Rico implemented a health care reform through the privatization of the public health system. The goal was to ensure access to health services, eliminate disparities for medically indigent citizens and provide special coverage for high-risk conditions such as cancer. This study estimates the 5-year relative survival rate of colorectal cancer and the relative excess risk of death in Puerto Rico for 2004–2005, by type of health insurance coverage; Government Health Plan vs. Non-Government Health Plan. Colorectal cancer in advanced stages was more common in Government Health Plan patients compared with Non-Government Health Plan patients (44.29% vs. 40.24 had regional extent and 13.58% versus 10.42% had distant involvement, respectively). Government Health Plan patients in the 50–64 (RR = 6.59; CI: 2.85–15.24) and ≥65 (RR = 2.4; CI: 1.72–4.04) age-groups had the greater excess risk of death compared with Non-Government Health Plan patients. Further studies evaluating the interplay of access to health services and the barriers affecting the Government Health Plan population are warranted.

Suggested Citation

  • Karen J Ortiz-Ortiz & Roberto Ramírez-García & Marcia Cruz-Correa & Moraima Y Ríos-González & Ana Patricia Ortiz, 2014. "Effects of Type of Health Insurance Coverage on Colorectal Cancer Survival in Puerto Rico: A Population-Based Study," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-8, May.
    • Handle: RePEc:plo:pone00:0096746
    DOI: 10.1371/journal.pone.0096746
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    References listed on IDEAS

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    1. Kelsall, Helen L. & Baglietto, Laura & Muller, David & Haydon, Andrew M. & English, Dallas R. & Giles, Graham G., 2009. "The effect of socioeconomic status on survival from colorectal cancer in the Melbourne Collaborative Cohort Study," Social Science & Medicine, Elsevier, vol. 68(2), pages 290-297, January.
    2. Butler, John & Foot, Catherine & Bomb, Martine & Hiom, Sara & Coleman, Michel & Bryant, Heather & Vedsted, Peter & Hanson, Jane & Richards, Mike, 2013. "The International Cancer Benchmarking Partnership: An international collaboration to inform cancer policy in Australia, Canada, Denmark, Norway, Sweden and the United Kingdom," Health Policy, Elsevier, vol. 112(1), pages 148-155.
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    Cited by:

    1. Karen J Ortiz-Ortiz & Guillermo Tortolero-Luna & Ruth Ríos-Motta & Alejandro Veintidós-Feliú & Robert Hunter-Mellado & Carlos R Torres-Cintrón & Tonatiuh Suárez-Ramos & Priscilla Magno, 2018. "Use of adjuvant chemotherapy in patients with stage III colon cancer in Puerto Rico: A population-based study," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-15, March.

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