Consistent health insurance is critical, finds new study

Inconsistent Medicaid enrollment was associated with a higher risk of death in pediatric cancer patients, according to a new study from the Brown School at Washington University in St. Louis.

Kim Johnson

“This paper underscores the importance of continuous access to health care for all children and adolescents,” said Kim Johnson, a professor at the Brown School and first author of “Associations between Medicaid enrollment and diagnosis stage and survival among pediatric cancer patients,” published in January in the journal Pediatric Blood & Cancer.

To evaluate Medicaid-associated disparities, Johnson and her co-authors used Surveillance, Epidemiology and End Results–Medicaid linked data to examine diagnosis stage and survival disparities in cancer cases diagnosed from birth-19 years old in those who were enrolled in Medicaid, the government health care insurance program for low-income people, with both intermittent and continuous enrollment.

Among 21,502 cases examined, higher odds of later-stage diagnoses were observed in association with Medicaid enrollment, with the highest odds when enrollment wasn’t continuous. Among 30,654 cases, researchers found a higher risk of cancer death in those with Medicaid enrollment, with the highest risk among those with intermittent enrollment.

However, Johnson cautioned that other factors may be at play, and further study is needed.

“Children and adolescents enrolled in Medicaid who are by definition low income have higher risks for cancer death than children and adolescents not enrolled in Medicaid,” she said. “Other factors that are associated with being low income besides having health insurance may be involved.

“Therefore, it is important to consider how the social determinants of health also play a role in these results,” she said. “These could include challenges in transportation and getting time off of work to attend to the child’s illness, among other factors.”

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