Insurance Impact on Outcomes for Rural Hematologic Patients | Kingsley Nnawuba, MD | ASH 2023

Hey everyone, my name is Kingsley Nnauba. I'm a PGY2 resident at the University of Arkansas for Medical Sciences, Northwest Regional Campus in Fayetteville, Arkansas. My research at ASH conference 2023 revolved around how various insurance companies or various insurance type rather affected hermatological malignancy outcomes. We looked at patients in the state of Arkansas and we looked at the patients between I believe 2013 to 2022 and we assessed how the various insurance types they had could result in their survival outcomes and the various types of care they could get access to. Interestingly, we had access to 2,400 patients there or thereabout and we analyzed them in terms of age, gender, sex and we also looked at them in terms of how long they had outcomes in terms of how long they survived. We found that insurance was the most significant variable in the outcomes for this patient. There were other factors you could also look at but the insurance types kind of made more outpute in terms of how they survived. Now the types of insurance we looked at were Medicare, Medicaid, we looked at private insurance, we also looked at the non-insured patients and the patient with military insurance. Understandably, the patients with Medicare had the age range above 65 but the average age we looked at in terms of all the patients we sampled was 66 and above. We did a multivariable analysis of our study and the only significant factor we could find in terms of patient outcome was the insurance type and the sex. We found that patients that had Medicare had very poor survival outcomes in their five-year plans while patients that had the private insurance lived for much longer. Interestingly, we understand that this could be due to several factors considering the fact that patients with Medicare sometimes have poorer access to like post-care like in terms of how they are cared for after they get cancer treatments and we also found out that patients with private insurance had better options in that aspect. We also understand that patients with Medicare are much older and there's a big chance that they would have a lot of comorbidities. When I say comorbidities, I mean things like having different other diseases like diabetes, hypertension, hyperlipidemia and this could in the long run affect how their survival shows up but these were not significant enough for us to be considering them so what really showed up significantly was the insurance types they had. This research is quite detailed and it gave us a lot of information however we're able to establish that the insurance type you had could eventually in the long run affect how you have your outcomes. Basically, if you had a private insurance the chances that you live longer after five years of treatment is kind of much higher compared to patients that had Medicare or Medicaid. Now we should also have in mind like I said that there were other co-founding factors such as comorbidities in terms of health and like age but however these were not as significant as the insurance types.