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Towards Equity in Specialized Cancer Care for Adolescents and Young Adults with Newly Diagnosed Acute Lymphoblastic Leukemia

Dr. Muffly

Lori Muffly


Stanford University

Project Term: June 1, 2023 - May 31, 2026

Our study is designed to directly inform the pathways through which health insurance influences access to care at an SCC for individuals with AYA ALL using a combination of cancer registry, survey, and cost-benefit analyses. This research will contribute to knowledge of the implications of health insurance coverage on ALL cancer care in young adults and inform policy-relevant solutions, including determining whether patients are bypassing an SCC for treatment at a more distant facility, calculating estimates of insurance acceptance and access challenges at ALL treating facilities and identifying the financial implications of shifting care to SCCs with demonstrated survival improvements for this population.

Lay Abstract

Research suggests that adolescents and young adults (AYAs) with newly diagnosed acute lymphoblastic leukemia (ALL) in the US experience improved survival when treated at a specialized cancer center (SCC). However, fewer than 50% of AYAs receive front-line ALL treatment at one of these designated sites. Health insurance may play a pivotal role in AYAs ability to access SCC-level care, yet this relationship is poorly understood. This project aims to understand how specific insurance types influence access to specialized ALL care and to provide insight into the costs and health benefits of switching care to an SCC. We will use data from statewide population-based datasets from California, New York, and Texas. The findings can potentially inform policy efforts to promote access to specialized cancer care among this underserved population of cancer patients.

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