The Affordable Care Act's Medicaid Expansion and Impact Along the Cancer-Care Continuum: A Systematic Review

Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and...

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Veröffentlicht in:JNCI : Journal of the National Cancer Institute Jg. 112; H. 8; S. 779
Hauptverfasser: Moss, Haley A, Wu, Jenny, Kaplan, Samantha J, Zafar, S Yousuf
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.08.2020
Schlagworte:
Continuity of Patient Care - economics
Continuity of Patient Care - organization & administration
Continuity of Patient Care - standards
Health Care Reform - economics
Health Care Reform - methods
Health Care Reform - organization & administration
Health Services Accessibility - economics
Health Services Accessibility - legislation & jurisprudence
Health Services Accessibility - organization & administration
Healthcare Disparities - economics
Healthcare Disparities - legislation & jurisprudence
Healthcare Disparities - organization & administration
Healthcare Disparities - statistics & numerical data
Humans
Insurance Coverage - economics
Insurance Coverage - legislation & jurisprudence
Insurance Coverage - organization & administration
Medicaid - economics
Medicaid - legislation & jurisprudence
Medicaid - organization & administration
Minority Groups - statistics & numerical data
Neoplasms - economics
Neoplasms - epidemiology
Neoplasms - therapy
Patient Protection and Affordable Care Act - economics
Poverty - economics
Poverty - statistics & numerical data
Preventive Medicine - economics
Preventive Medicine - methods
Preventive Medicine - organization & administration
Preventive Medicine - statistics & numerical data
Quality Improvement - economics
Quality Improvement - organization & administration
Quality Improvement - standards
Survival Analysis
Terminal Care - economics
Terminal Care - organization & administration
Terminal Care - standards
United States - epidemiology
United States
ISSN:1460-2105, 1460-2105
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Zusammenfassung:Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and Affordable Care Act in the context of cancer care. The purpose of this article is to summarize the currently published literature and to determine the effects of Medicaid expansion on outcomes during points along the cancer care continuum. A systematic search for relevant studies was performed in the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases. Three independent observers used an abstraction form to code outcomes and perform a quality and risk of bias assessment using predefined criteria. A total of 48 studies were identified. The most common outcomes assessed were the impact of Medicaid expansion on insurance coverage (23.4% of studies), followed by evaluation of racial and/or socioeconomic disparities (17.4%) and access to screening (14.5%). Medicaid expansion was associated with increases in coverage for cancer patients and survivors as well as reduced racial- and income-related disparities. Medicaid expansion has led to improved access to insurance coverage among cancer patients and survivors, particularly among low-income and minority populations. This review highlights important gaps in the existing oncology literature, including a lack of studies evaluating changes in treatment and access to end-of-life care following implementation of expansion.
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ISSN:1460-2105
1460-2105
DOI:10.1093/jnci/djaa043