Trends in the use of proton beam therapy among newly diagnosed cancer patients in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6551-6551
Author(s):  
Leticia Maciel Nogueira ◽  
Jason A. Efstathiou ◽  
Helmneh M. Sineshaw ◽  
K Robin Yabroff ◽  
Ahmedin Jemal
Keyword(s):  
Health Insurance ◽  
Cancer Patients ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Proton Beam Therapy ◽  
Health Insurance Coverage ◽  
Newly Diagnosed ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

6551 Background: Proton Beam Therapy (PBT) is a potentially superior radiotherapy technology for tumors with complex anatomy surrounded by sensitive tissues and for childhood cancers where sparing surrounding normal tissue is better achieved than with photon radiotherapy. The first conditions for payment of PBT claims went into effect in 2009. In 2014, the American Society of Radiation Oncology categorized PBT clinical indications into Group 1, for which health insurance coverage is recommended, and Group 2, for which coverage is recommended only if additional requirements are met. Methods: We evaluated 21,920 newly diagnosed patients in the National Cancer Database (NCDB) who received PBT between 2004 and 2016. Joinpoint analyses were used to evaluate the Annual Percent Change (APC) in the number and characteristics of patients treated with PBT. Results: The number of patients treated with PBT in NCDB facilities increased from 1,114 in 2004 to 3,173 in 2016 (APC = 8.78, p < .001), due mainly to increases in Group 1 cancers after 2010 (from 271 patients in 2010 to 1,124 in 2016, APC = 26.4, p < .001). The number of Group 2 patients treated with PBT increased slower (from 937 in 2004 to 2,049 in 2016, APC = 6.1, p < .05). Breast and prostate cancers were most common, although trends varied substantially by cancer site. Between 2010 and 2016, receipt of PBT increased for breast cancer patients from 40 in 2010 to 405 in 2016 (APC = 48.5, p < .001), but decreased for prostate cancer patients from 1,205 in 2011 to 680 in 2016 (APC = -14.06, p < .001). While most of Group 1 patients had private insurance coverage (59.3% of patients treated in 2016), Medicare was the most common primary insurance type among Group 2 patients (50% of patients treated in 2016). Conclusions: The number of newly diagnosed cancer patients treated with PBT has increased between 2004 to 2016 in the US, with a sharp increase for cancers with clinical indications for health insurance coverage since 2010. While most of these patients have private insurance coverage, the steady increase in the number of patients being treated with PBT for cancers with additional requirements for health insurance coverage is primarily in those with Medicare coverage.

Autism and Families' Financial Burden: The Association With Health Insurance Coverage

2015 ◽  
Vol 120 (2) ◽  
pp. 166-175 ◽  
Author(s):  
Susan L. Parish ◽  
Kathleen C. Thomas ◽  
Christianna S. Williams ◽  
Morgan K. Crossman
Keyword(s):  
Health Insurance ◽  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Autism Spectrum ◽  
Medical Expenditure ◽  
Outpatient Services ◽  
Raising Children

Abstract We examined the relationship between family financial burden and children's health insurance coverage in families (n  =  316) raising children with autism spectrum disorders (ASD), using pooled 2000–2009 Medical Expenditure Panel Survey data. Measures of family financial burden included any out-of-pocket spending in the previous year, and spending as a percentage of families' income. Families spent an average of $9.70 per $1,000 of income on their child's health care costs. Families raising children with private insurance were more than 5 times as likely to have any out-of-pocket spending compared to publicly insured children. The most common out-of-pocket expenditure types were medications, outpatient services, and dental care. This study provides evidence of the relative inadequacy of private insurance in meeting the needs of children with ASD.

The Impact Of Health Insurance Coverage On Outcomes For U.S. Gastric Cancer Patients

2011 ◽  
Vol 165 (2) ◽  
pp. 338
Author(s):  
J.K. Smith ◽  
S. Ng ◽  
J.S. Hill ◽  
T.P. McDade ◽  
S.A. Shah ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Health Insurance ◽  
Cancer Patients ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Gastric Cancer Patients ◽  
The Impact

Health Insurance Stability and Health Status

2008 ◽  
Vol 29 (11) ◽  
pp. 1471-1491 ◽  
Author(s):  
Robert B. Nielsen ◽  
Steven Garasky
Keyword(s):  
Health Insurance ◽  
Multivariate Analyses ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Adult Health ◽  
Program Participation ◽  
Public And Private ◽  
Policy Makers ◽  
Personal Insurance

Being uninsured affects one's ability to access medical services and maintain health. Using longitudinal data from the Survey of Income and Program Participation, the authors investigated how individual and family insurance coverage affects adult health. They found that health insurance coverage often varies across family members and changes frequently. Employing multivariate analyses that control for personal insurance status, predisposing characteristics, and enabling resources, the authors show that adults who are members of families that include other uninsured members are more likely to report poor health than adults in full-coverage families. Policy makers should consider refocusing public and private insurance coverage goals to include full-family coverage.

Transitional Subsidies for Health Insurance Coverage

2001 ◽  
Vol 38 (2) ◽  
pp. 225-231 ◽  
Author(s):  
Jonathan Gruber
Keyword(s):  
Health Insurance ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Recent Past ◽  
Waiting Period ◽  
Low Incomes ◽  
Loan Program ◽  
The Cost

Losing or leaving a job often means losing health insurance. Of all those who have lost private insurance and become uninsured, one-third have either left or lost a job in the recent past. Continuation of coverage subsidies under the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 mitigate only slightly this problem due to the high costs of the group coverage that must be purchased. This paper discusses a proposal to build on the successes of COBRA to extend insurance to this important population. The key components are: a doubling of the length of COBRA entitlement to 36 months; eligibility for workers in all firms, not just those with more than 20 employees, but with a waiting period of one to two years; the establishment of a new COBRA-LOAN program that would offer government loans to help enrollees pay the cost of COBRA while they searched for new opportunities; and forgiveness of repayments after the entitlement period for those with low incomes.

scholarly journals Problems of health insurance coverage and health care in the United States: public and private solution strategies

1992 ◽  
Vol 8 (3) ◽  
pp. 270-286
Author(s):  
E. Richard Brown
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Care Financing ◽  
Health Insurance Coverage ◽  
The United States ◽  
Political Debate ◽  
Financing System

A nearly universal consensus has developed in the United States that the current health care financing system is a failure. The system has been unable to control the continuing rapid rise in health care costs (by far, the highest in the world), and it has been unable to stem the growing population that has no health insurance coverage (at least 36 million people). There is nearly universal political agreement that government must provide health insurance to a far greater share of the population than ever before. The political debate now focuses on whether this expanded government role should supplement the private insurance system with an enlarged public program covering those left out of private insurance coverage, or replace private insurance with a universal government health insurance program covering the entire population.

scholarly journals Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study

2008 ◽  
Vol 45 (1) ◽  
pp. 28-33
Author(s):  
Fernando O. Souza ◽  
Dalnei V. Pereira ◽  
Luís H. Santos ◽  
Luis Antunes ◽  
Juarez Chiesa
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Survival Rates ◽  
University Hospital ◽  
Surgical Team ◽  
Pathologic Features ◽  
Number Of Patients ◽  
Group 2 ◽  
Gastric Cancer Patients ◽  
Group 1

BACKGROUND: Although gastric cancer has been decreasing in incidence in many countries, it is still the second most common cause of cancer deaths worldwide. Its prognosis is poor and depends, among other factors, on early diagnosis as well as on surgeon expertise. AIM: To compare the outcomes of gastric cancer patients treated at a university hospital by a general surgical team and later on by a gastric cancer surgical team. METHODS: Gastric cancer patients were separated into two groups according to whether they were treated by a general surgical team (group 1, n = 136; 1984 to 1993) or by gastric cancer team (group 2, n = 149; 1994 to 2003). Clinical and pathologic features and survival rates were assessed. RESULTS: During a 20-year period, a decreased number of patients underwent surgical resection in the second period (94% vs 86%), a greater number of upper gastrointestinal endoscopies were performed resulting in an increased number of tumors diagnosed as stage I (5% vs 22%). Also, D2 gastrectomies were more frequently performed instead of D0 gastrectomies and negative surgical margins were adequate. Mortality decreased from 9% to 6% in group 1 and 2, respectively and adjuvant therapy has been considered. CONCLUSION: Surgical specialized units for gastric cancer are necessary if better results are to be expected since this approach definitely provides better patient care.

scholarly journals INNV-09. CLINICAL EFFICACY OF TUMOR TREATING FIELDS FOR NEWLY DIAGNOSED GLIOBLASTOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi132-vi132
Author(s):  
Yang Liu ◽  
Myla Strawderman ◽  
Kwanza Warren ◽  
Margie Richardson ◽  
Jennifer Serventi ◽  
...  
Keyword(s):  
Cox Model ◽  
Performance Status ◽  
Survival Rates ◽  
Poisson Model ◽  
Newly Diagnosed ◽  
Tumor Treating Fields ◽  
Number Of Patients ◽  
Group 2 ◽  
Stupp Protocol ◽  
Group 1

Abstract Recent clinical trials demonstrated that adding tumor treating fields (TTF) to radiotherapy and temozolomide chemotherapy (the Stupp protocol) increased survival for glioblastoma (GBM) patients. However, data is lacking on the magnitude of this survival effect when the regimen is used outside of a clinical trial as part of routine clinical practice. In the present study, we retrospectively identified adult patients with newly diagnosed GBM (n = 240) treated with the Stupp protocol at our institution from January 2005 to July 2017. We grouped patients into two time periods for comparison: 2005–2013 (group 1, Stupp protocol) and 2014–2017 (group 2, TTF+ Stupp protocol). Thirty-six percent (37/104) of patients in group 2 received TTF in conjunction with the Stupp protocol. Within group 2, the 37-patients who received TTF + Stupp had increased 6-month and 1-year survival rates compared to the 67-patients who received Stupp alone (97.1% vs. 75.7%, p = 0.006; 67.6% vs. 53.7%, p = 0.170, respectively). The improvement of survival rate at 6-month was further confirmed by a modified Poisson model (RR: 1.23, p = 0.010) adjusting for sex, age, performance status and extent of resection. However, we did not observe improvements in overall survival (OS) with a Cox model with TTF treatment modeled as a time-dependent covariate (HR = 0.87, p = 0.599). Furthermore, we did not find that the addition of TTF as a treatment option in our center significantly improved OS for patients in group 2 when compared to those in group 1 (429.0 vs. 395.0 days, p = 0.138). Therefore, while adding TTF to the Stupp protocol appeared to benefit patients with newly diagnosed GBM, this effect may be largely due to selection bias. Comprehensive studies including large number of patients as well as longer follow-up time are needed to validate our results.

scholarly journals Telepsychiatry and Medical Insurance: Comparative Perspectives Between India and the United States

2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 92S-97S
Author(s):  
P Lakshmi Nirisha ◽  
Srinagesh Mannekote Thippaiah ◽  
Rachel E. Fargason ◽  
Barikar C Malathesh ◽  
Narayana Manjunatha ◽  
...  
Keyword(s):  
United States ◽  
Health Insurance ◽  
United States Of America ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Cost Effective ◽  
Health Insurance Coverage ◽  
The United States ◽  
Regulatory Policies ◽  
Cost Effective Alternative

Telepsychiatry is a cost-effective alternative to in-person psychiatric consultations. The COVID-19 pandemic brought about a sharp spike in the utilization of telepsychiatry due to ongoing restrictions on gatherings and traveling. In recognition of the importance of telemedicine in general, and telepsychiatry specifically, telemedicine practice guidelines and telepsychiatry operational guidelines have been released. Due to the rising trend in telemedicine, the Insurance Regulatory and Development Authority of India (IRDIA) incorporated teleconsultation health insurance coverage at a level on par with regular in-person consultations. In contrast, in the United States of America, private insurance coverage for telepsychiatry has been in vogue for some time. In this paper we draw comparisons between India and the United States on telepsychiatry and health insurance. We compare the evolving regulatory policies of these two countries in relation to existing insurances plans that are available, the challenges in implementation of new regulations and the possible ways to overcome the challenges to make telepsychiatry affordable to all.

Does health insurance coverage improve outcomes for U.S. pancreatic cancer patients?

2010 ◽  
Vol 211 (3) ◽  
pp. S109
Author(s):  
Jillian K. Smith ◽  
SiNg Chau Ng ◽  
James E. Carroll ◽  
Theodore P. McDade ◽  
Shimul A. Shah ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Health Insurance ◽  
Cancer Patients ◽  
Insurance Coverage ◽  
Health Insurance Coverage
Sign in / Sign up

Export Citation Format

Share Document