MD Anderson Cancer Center
Project Term: June 1, 2023 - May 31, 2026
In this proposal we will investigate the association between insurance coverage and access to care, survival, and financial hardship among patients across Non-Hodgkin lymphoma (NHL) subtypes and to what extent insurance coverage explains and modifies racial disparity in access to care and outcomes. To this end, we will use the Optum Clinformatics DataMart database, the Texas Cancer Registry, the Harris Health System Cancer Database and Data from the Lymphoma Epidemiology of Outcomes (LEO) Cohort Study. These four databases will provide a sample that covers a diverse patient population in terms of insurance coverage, race and ethnicity, and geographic regions. The LEO Cohort Study also provides information on self-reported financial toxicity that is not available in cancer registries, administrative claims data, or surveys. This study will reveal whether insurance coverage, neighborhood socioeconomic factors and healthcare resources are associated with access to care and outcomes of NHL patients.
With the rising costs of cancer care, patients are more likely to experience financial hardship. It is generally understood that a lack of adequate health insurance contributes to this financial hardship among cancer patients, with demographic characteristics such as race, ethnicity, and income playing a role as well. However, there is a lack of specific knowledge on the prevalence of financial hardship, the impact of health insurance, and whether and to what extent hardship affects quality of life and mortality among patients with non-Hodgkin lymphoma (NHL). This work aims to address this gap by exploring the role of insurance coverage in access to care, survival, and financial hardship among patients with NHL and to what extent insurance coverage influences racial disparities in access and outcomes. Patient data will be drawn from a long-term follow up study of patients with lymphoma treated at eight cancer centers in the U.S. as well as a national database of insurance claims. These findings may provide evidence that policymakers can use to guide insurance coverage policymaking to reduce disparities in access to care.