Can the Health Care System Manage Increased Workloads From Expanded Access to Cancer Treatment?
Year: 2021
Type: article
Abstract: It has become increasingly clear that the Patient Protection and Affordable Care Act (ACA) and the expansion of insurance it offers have led to improved access to cancer care with earlier stage at diagnosis and quality improvements. For example, the most recent estimate for gynecologic cancers is a 0.8% increase in 1-year survival, and a reduction in delays from diagnosis to treatment. 2 More specifically, Medicaid expansion, included in the ACA, improved insurance coverage, increased earlier stage diagnosis, improved treatment at an academic facility and within 30 days, with larger gains seen for cervical cancer, Hispanic populations, and low-income codes. A similar small but important shift was seen for other cancer types as well (ie, pancreas, melanoma, breast, colorectal, and lung). 4 This earlier stage of diagnosis secondarily has led to increased cancer incidence. This increased incidence then translates to growing demand for cancer care. Frosch et al 5 asked and sought to answer the query of whether this increased demand and growth in hospital volume leads to delays in care or worse outcomes and where we may see inflection points (ie, community cancer centers vs National Cancer Institute [NCI] cancer centers and academic hospitals). The NCI centers have some of the best outcomes in the United States. 6 Moreover, we have known for at least 20 years of the strong association between high volume 7,8 and the use of guidelines 9 with better quality of care. Yet health systems must remain vigilant and cognizant of local and national policy needs to address this group of patients.
Source: JAMA Network Open
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,000
OpenAlex ID: W3181910472