title: Lung Cancer Care Before and After Medicare Eligibility.
abstract: Uninsured and underinsured near-elderly may not have timely investigation, diagnosis, or care of cancer. Prior studies suggest Medicare eligibility confers significant and substantial reductions in mortality and increases in health service utilization. We compared 2245 patients diagnosed with lung cancer at ages 64.5 to 65 years and 2512 patients aged 65 to 65.5 years, with 2492 patients aged 65.5 to 66 years (controls) in 2000 to 2005. Compared with controls, patients diagnosed with lung cancer before Medicare eligibility had no statistically significant differences in cancer stage, time to treatment, type of treatment, and survival. Study power was sufficient to exclude mortality reductions and health service utilization changes of the magnitude found in prior work, suggesting that typically, appropriate lung cancer care may be sought and delivered regardless of insurance status.
authors.affiliation: University of Southern California, Los Angeles, USA huesch@usc.edu.
authors.forename: Marco D
authors.initials: MD
authors.lastname: Huesch
authors.affiliation: University of California, Los Angeles, USA University of California, Los Angeles, USA.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Ong
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D017057:Medically Uninsured; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D009367:Neoplasm Staging; D018426:SEER Program; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States
keywords: Medicare; access; cancer; care; coverage; insurance; near elderly; uninsured