The Impact of the Affordable Care Act on Insurance Coverage and Stage Among Head and Neck Squamous Cell Carcinoma Patients

Krupal B. Patel, Sepehr Shabani, Tapan Padhya, Biwei Cao, Xuefeng Wang, Kea Turner, Anthony C. Nichols, Stephen Y. Kang, James W. Rocco, Matthew Old

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

The purpose was to examine the change in percent uninsured and if there is change in T-stage, N- stage and overall- stage among nonelderly patients with newly diagnosed head and neck squamous cell carcinoma after the Affordable Care Act (ACA). The National Cancer Database was used for this study. Patients were divided between pre-ACA and post-ACA implementation with stratification between areas of ACA expansion versus non- expansion. A quasi- experimental difference- in-difference study design was undertaken. A total of 15,037 patients met the inclusion criteria. Between the pre-ACA and post-ACA periods, there was increase in proportion of percent insured with Medicaid coverage in patients residing in expansion region. There was a decrease in the proportion of patients who had advanced Tumor stage and Nodal stage decreased after implementation of ACA. With the implementation of ACA expansion, there is increased Medicaid coverage, correspond-ing to a decreased proportion of patients presenting with advanced T-stage and N- stage.

Original languageEnglish (US)
Pages (from-to)1322-1336
Number of pages15
JournalJournal of Health Care for the Poor and Underserved
Volume33
Issue number3
DOIs
StatePublished - Aug 2022
Externally publishedYes

Keywords

  • ACA
  • Affordable Care Act
  • Head and neck cancer
  • NCDB
  • National Cancer Database
  • insurance coverage

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Fingerprint

Dive into the research topics of 'The Impact of the Affordable Care Act on Insurance Coverage and Stage Among Head and Neck Squamous Cell Carcinoma Patients'. Together they form a unique fingerprint.

Cite this