Insurance Type Linked to Surgery Delay in Melanoma
WEDNESDAY, Oct. 4, 2017 -- Patients diagnosed with melanoma are more likely to have treatment delays if they are nonwhite or on Medicaid, while delays are less likely for patients diagnosed or treated by a dermatologist, according to a study published online Oct. 4 in JAMA Dermatology.
Adewole S. Adamson, M.D., M.P.P., from the University of North Carolina at Chapel Hill, and colleagues conducted a retrospective cohort study of patients who were diagnosed with melanoma to assess factors associated with delays between diagnosis and surgery. The researchers used data from the North Carolina Cancer Registry linked to administrative claims from Medicare, Medicaid, and private insurance. Data were included for 7,629 patients: 48 percent Medicare, 48 percent privately insured, and 4 percent Medicaid.
The researchers found that the likelihood of experiencing a delay in definitive surgery was lowest for privately insured patients, followed by Medicare and Medicaid patients (14, 17, and 24 percent, respectively). The risk of surgical delay was significantly increased in patients with Medicaid versus private insurance after demographic adjustment (risk ratio, 1.36). Nonwhite patients were more likely to have delays (risk ratio, 1.38). If the physician performing the surgery or the diagnosing clinician was a dermatologist versus a nondermatologist, surgical delays were less likely (risk ratio, 0.82 and 0.81, respectively).
"A reduction in delays in melanoma surgery could be achieved through better access to specialty care and cross-disciplinary coordination," the authors write.
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Posted: October 2017