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Effects of health insurance and race on colorectal cancer treatments and outcomes

Author

Listed:
  • Roetzheim, R.G.
  • Pal, N.
  • Gonzalez, E.C.
  • Ferrante, J.M.
  • Van Durme, D.J.
  • Krischer, J.P.

Abstract

Objectives. We hypothesized that health insurance payer and race might influence the care and outcomes of patients with colorectal cancer. Methods. We examined treatments received for all incident cases of colorectal cancer occurring in Florida in 1994 (n=9551), using state tumor registry data. We also estimated the adjusted risk of death (through 1997), using proportional hazards regression analysis controlling for other predictors of mortality. Results. Treatments received by patients varied considerably according to their insurance payer. Among non-Medicare patients, those in the following groups had higher adjusted risks of death relative to commercial fee-for-service insurance: commercial HMO (risk ratio [RR]=1.40; 95% confidence interval [CI]=1.18, 1.67; P=.0001), Medicaid (RR=1.44; 95% CI=1.06, 1.97; P=.02), and uninsured (RR=1.41; 95% CI=1.12, 1.77; P=.003). Non-Hispanic African Americans had higher mortality rates (RR=1.18; 95% CI=1.01, 1.37; P=.04) than non-Hispanic Whites. Conclusions. Patients with colorectal cancer who were uninsured or insured by Medicaid or commercial HMOs had higher mortality rates than patients with commercial fee-for-service insurance. Mortality was also higher among non-Hispanic African American patients.

Suggested Citation

  • Roetzheim, R.G. & Pal, N. & Gonzalez, E.C. & Ferrante, J.M. & Van Durme, D.J. & Krischer, J.P., 2000. "Effects of health insurance and race on colorectal cancer treatments and outcomes," American Journal of Public Health, American Public Health Association, vol. 90(11), pages 1746-1754.
    • Handle: RePEc:aph:ajpbhl:2000:90:11:1746-1754_0
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    Cited by:

    1. Stacey L Tannenbaum & Monique Hernandez & D Dandan Zheng & Daniel A Sussman & David J Lee, 2014. "Individual- and Neighborhood-Level Predictors of Mortality in Florida Colorectal Cancer Patients," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-10, August.
    2. Gowrisankaran Gautam & Town Robert & Barrette Eric, 2011. "Managed Care, Drug Benefits and Mortality: An Analysis of the Elderly," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(2), pages 1-32, January.
    3. Rebecca M. Myerson & Reginald D. Tucker‐Seeley & Dana P. Goldman & Darius N. Lakdawalla, 2020. "Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 577-604, June.
    4. Jang, Sung-In & Yi, Sang-Wook & Sull, Jae-Woong & Park, Eun-Cheol & Kim, Jae-Hyun & Ohrr, Heechoul, 2015. "Association between all-cause mortality and insurance status transition among the elderly population in a rural area in Korea: Kangwha Cohort Study," Health Policy, Elsevier, vol. 119(5), pages 680-687.
    5. Jung-kyu Choi & Se-Hyung Kim & Myung-Bae Park, 2021. "Association between Moving to a High-Volume Hospital in the Capital Area and the Mortality among Patients with Cancer: A Large Population-Based Cohort Study," IJERPH, MDPI, vol. 18(7), pages 1-11, April.
    6. Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    7. Grann, Victor & Troxel, Andrea B. & Zojwalla, Naseem & Hershman, Dawn & Glied, Sherry A. & Jacobson, Judith S., 2006. "Regional and racial disparities in breast cancer-specific mortality," Social Science & Medicine, Elsevier, vol. 62(2), pages 337-347, January.

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