Dataset Information

Late-Stage Oral Cancer Detection After California and Illinois Restored Medicaid Dental Benefits.

ABSTRACT:

Objective

Previous research found an association between California's Medicaid dental coverage and oral cancer detection. However, this relationship has yet to be explored in other states or by subgroup populations.

Study design

In addition to controlling for sociodemographic and tumor characteristics, this study implemented a traditional difference-in-differences design to compare distant-stage diagnosis trends in states restoring Medicaid dental benefits (California [CA] and Illinois [IL]) with trends in states with constant Medicaid dental benefits.

Setting

This retrospective, observational study analyzed oral cavity and pharynx cancer case data from The Surveillance, Epidemiology, and End Results program (2004-2017).

Methods

The outcome was a binary variable indicating whether a patient was diagnosed at a distant stage. Subgroup analyses were conducted by state, race/ethnic group, sex, age, and county-level household income.

Results

The sample included 109,997 adults diagnosed with cancer of the oral cavity and pharynx. Restoring Medicaid dental benefits was associated with a statistically significant 2.7%-point decline in the probability of a distant-stage oral cancer diagnosis. This estimate represented a 14% relative change from baseline rates. Results were consistent for CA and IL and by county-level median income. Estimates were significantly larger for adults under age 65, males, and adults identifying as Hispanic; non-Hispanic Black; American Indian; or Asian American or Pacific Islander.

Conclusion

Restoring Medicaid dental coverage improved early detection in both CA and IL, with the greatest reductions in distant-stage diagnoses occurring in younger adults, males, and minoritized racial/ethnic groups. Future research should investigate whether earlier detection reduces oral cancer mortality disparities.

SUBMITTER: Semprini JT

PROVIDER: S-EPMC10790188 | biostudies-literature | 2024 Jan-Mar

REPOSITORIES: biostudies-literature

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Publications

Late-Stage Oral Cancer Detection After California and Illinois Restored Medicaid Dental Benefits.

Semprini Jason T JT

OTO open 20240116 1

<h4>Objective</h4>Previous research found an association between California's Medicaid dental coverage and oral cancer detection. However, this relationship has yet to be explored in other states or by subgroup populations.<h4>Study design</h4>In addition to controlling for sociodemographic and tumor characteristics, this study implemented a traditional difference-in-differences design to compare distant-stage diagnosis trends in states restoring Medicaid dental benefits (California [CA] and Ill ...[more]

PMID: 38229972

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Project description:BackgroundMany people seeking abortion encounter financial difficulties that delay or prevent them from accessing care. Although some patients qualify for Medicaid (a public program that can help cover health care costs), laws in some states restrict the use of Medicaid for abortion care. In 2017, Illinois passed House Bill 40 (HB-40), which allowed patients with Medicaid to receive coverage for their abortion. This study aimed to understand how HB-40 affected abortion affordability from the perspectives of individuals that work directly or indirectly with abortion patients or facilities providing abortion care.MethodsWe conducted interviews with clinicians and administrators from facilities that provided abortion services; staff from organizations that provided resources to abortion providers or patients; and individuals at organizations involved in the passage and/or implementation of HB-40. Interviews were audio-recorded and transcribed. We created codes based on the interview guides, coded each transcript using the web application Dedoose, and summarized findings by code.ResultsInterviews were conducted with 38 participants. Participants reflected that HB-40 seemed to remove a significant financial barrier for Medicaid recipients and improve the experience for patients seeking abortion care. Participants also described how the law led to a shift in resource allocation, allowing financial support to be directed towards uninsured patients. Some participants thought HB-40 might contribute to a reduction in abortion stigma. Despite the perceived positive impacts of the law, participants noted a lack of public knowledge about HB-40, as well as confusing or cumbersome insurance-related processes, could diminish the law's impact. Participants also highlighted persisting barriers to abortion utilization for minors, recent and undocumented immigrants, and people residing in rural areas, even after the passage of HB-40.ConclusionsHB-40 was perceived to improve the affordability of abortion. However, participants identified additional obstacles to abortion care in Illinois that weakened the impact of HB-40 for patients and required further action, Findings suggest that policymakers must also consider how insurance coverage can be disrupted by other legal barriers for historically excluded populations and ensure clear information on Medicaid enrollment and abortion coverage is widely disseminated.

Dataset Information

Late-Stage Oral Cancer Detection After California and Illinois Restored Medicaid Dental Benefits.

Objective

Study design

Setting

Methods

Results

Conclusion

Publications

Late-Stage Oral Cancer Detection After California and Illinois Restored Medicaid Dental Benefits.

Similar Datasets

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