Insurance affects quality of care for kidney cancer patients

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Researchers have found that insurance coverage may not only affect a patient's access to healthcare, but also the quality of care they receive, which may have implications for the U.S. debate on healthcare reform, according to findings presented April 25 at the American Urological Association's (AUA) annual meeting in Chicago.

"We discovered a discrepancy in the type of surgical treatment patients are offered based on their health insurance," said the study's lead author Robert G. Uzzo, MD, chairman of the department of surgery at Fox Chase Cancer Center in Philadelphia. His research evaluated differences in surgical treatment for kidney cancer based on a patient's health insurance carrier.

The study evaluated the potential impact of a patient's primary insurance status as it relates to the likelihood of the patient undergoing a radical or partial nephrectomy. The study relied on inpatient discharge data from nearly 42,000 adult patients in New York, New Jersey and Pennsylvania over a six-year period.

The results showed that kidney cancer patients with Medicare as their primary payor were more likely to have their kidney surgically removed entirely (radical nephrectomy), whereas those with private insurance were offered surgery to preserve organ function (partial nephrectomy).

"The notion that the kind of insurance you have can affect the quality of the care you receive has implications for the ongoing discussion about national healthcare reform. This research raises important questions for the government to consider," Uzzo added. "As our national leaders begin to discuss healthcare reform, it will be important to keep in mind that who pays for the care can affect the quality of care received."

The researchers said that their results revealed that disparities in quality of care exist. Patients 65 and over, with Medicare coverage, were significantly less likely to undergo kidney-sparing surgery for treatment of renal malignancy (kidney cancer), than patients whose primary payor was a private insurance carrier.

There are numerous long-term health benefits to patients when the non-cancerous portion of the kidney can be preserved, according to the authors. These include preserving maximum kidney function, reducing the risk of dialysis down the road and a longer life expectancy.