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Health insurance coverage and cost barriers to needed medical care among U.S. adult cancer survivors age <65 years
Author(s) -
Sabatino Susan A.,
Coates Ralph J.,
Uhler Robert J.,
Alley Linda G.,
Pollack Lori A.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21879
Subject(s) - medicine , marital status , ethnic group , national health interview survey , demography , health insurance , health care , public health , gerontology , public health insurance , cancer , environmental health , population , nursing , sociology , anthropology , economics , economic growth
BACKGROUND The health insurance and cost barriers to care among cancer survivors age <65 years were examined. METHODS Using the 1998 and 2000 National Health Interview Survey, survivors ages 18 to 64 years ( n = 1718) were compared with similarly aged adults without cancer ( n = 50,276) to examine health insurance and reported delayed/missed needed medical care within the previous year because of cost. Findings were initially adjusted for age, sex, race, and ethnicity, and further adjusted for employment, income, health status, marital status, and region. RESULTS Before adjustment, survivors were less likely to be uninsured (12.4% vs. 18.0%) and more likely to have public insurance (11.2% vs. 6.2%). After initial adjustment, survivors were as likely to lack insurance, less likely to have private insurance, and more likely to have public insurance. After further adjusting, differences in being uninsured were found to be small, differences in having private insurance were eliminated, and differences in having public insurance were reduced. Survivors most likely to lack insurance were younger, female, African‐American, or lower income. Survivors, particularly uninsured or publicly insured survivors, were more likely to delay/miss care because of cost. Overall, 20.9% of survivors, including 68% of uninsured survivors, reported delaying/missing needed care. CONCLUSIONS Health insurance coverage among cancer survivors age <65 years appears to be comparable to that of adults of similar age, sex, race, and ethnicity, but survivors may more likely be publicly insured. Differences are attributable in part to employment, income, and health status, factors potentially influenced by cancer. Unmet medical care needs because of cost were common among survivors, particularly uninsured survivors. Cancer 2006. © 2006 American Cancer Society.