Impact of Insurance Status on Radiation Treatment Modality Selection Among Potential Candidates for Prostate, Breast, or Gynecologic Brachytherapy.

The Patient Protection and Affordable Care Act looks to expand both private and Medicaid insurance. To evaluate how these changes may affect the field of radiation oncology, we evaluated the association of insurance status with the use of brachytherapy in cancers for which this treatment technique is used.

A total of 190,467 patients met the inclusion criteria, of whom 95,292 (50. 0%) had breast cancer, 61,096 (32. 1%) had prostate cancer, 28,194 (14. 8%) had endometrial cancer, and 5885 (3. 1%) had cervical cancer. A multivariate logistic regression model was used to determine the association between insurance status and receipt of brachytherapy among patients treated definitively for prostate and cervical cancer or postoperatively for breast and endometrial cancer.

The rates of non-Medicaid insurance were 49. 9% (cervical), 85. 3% (endometrial), 87. 4% (breast), and 90. 9% (prostate) (P

Despite being a cost-effective treatment modality, brachytherapy is less often used in the definitive or postoperative management of cancer in patients with Medicaid coverage or without insurance. Upcoming health policy changes resulting in the expansion of private insurance and Medicaid will likely increase access to and demand for brachytherapy.

International journal of radiation oncology, biology, physics. 2015 Aug 28 [Epub ahead of print]

Stephen R Grant, Gary V Walker, Matthew Koshy, Simona F Shaitelman, Ann H Klopp, Steven J Frank, Thomas J Pugh, Pamela K Allen, Usama Mahmood

Baylor College of Medicine, Houston, Texas. , Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. , Department of Radiation Oncology, The University of Chicago, Chicago, Illinois. , Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. , Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. , Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. , Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. , Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. , Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.

PubMed

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