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Lower-Insurance Mortality Unaffected by Comorbidities

Last Updated: May 27, 2009.

Comorbidity levels do not explain why patients with colorectal cancer who have private insurance have lower death rates than patients who are uninsured or have government insurance, according to a study published online May 26 in the Journal of Clinical Oncology. In a related study in the same issue, hospital factors such as quality can help explain some of the higher mortality in black patients with breast or colon cancer.

WEDNESDAY, May 27 (HealthDay News) -- Comorbidity levels do not explain why patients with colorectal cancer who have private insurance have lower death rates than patients who are uninsured or have government insurance, according to a study published online May 26 in the Journal of Clinical Oncology. In a related study in the same issue, hospital factors such as quality can help explain some of the higher mortality in black patients with breast or colon cancer.

In the first study, Anthony S. Robbins, M.D., and colleagues from the American Cancer Society in Atlanta analyzed data from 64,304 white and black patients with colorectal cancer to determine whether comorbidity levels explain why insurance status predicts survival. They found that patients with private insurance had the lowest level of comorbidities and the best survival compared with patients who were uninsured or receiving Medicaid or Medicare, but adjusting for the number of comorbidities had little impact on the association between insurance status and survival.

In the second study, Tara M. Breslin, M.D., and colleagues from the University of Michigan in Ann Arbor analyzed data on hospital factors and late mortality from 25,571 black and white breast cancer patients and 22,168 black and white colon cancer patients. The researchers found that black patients had a significantly higher risk of mortality for both breast (hazard ratio, 1.25) and colon cancer (hazard ratio, 1.13). Hospital factors could explain 36 percent of the excess mortality for breast cancer and 54 percent of the excess mortality for colon cancer.

"Hospital factors, including quality, are important mediators of the association between race and mortality for breast and colon cancer," Breslin and colleagues conclude.

Abstract - Robbins
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Abstract - Breslin
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