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Role of Patient Characteristics and Insurance Type in Newly Diagnosed Multiple Myeloma Care Disparities.
- Source :
- JCO Oncology Practice; May2024, Vol. 20 Issue 5, p699-707, 10p
- Publication Year :
- 2024
-
Abstract
- PURPOSE Little is known about the role of social determinants of health (SDOH) in the utilization of novel treatments among patients with newly diagnosed multiple myeloma (NDMM). METHODS This retrospective cohort study used Taussig Cancer Center's Myeloma Patient Registry to identify adults with NDMM between January 1, 2017, and December 31, 2021. Electronic health records data captured treatment with (1) triplet or quadruplet regimen and (2) lenalidomide during the first year after NDMM, and (3) stem-cell transplant (SCT) through December 31, 2022. Multivariable logistic regression models examined associations of demographic/clinical characteristics and SDOH with care patterns. RESULTS We identified 569 patients with median age at diagnosis of 66 years (IQR, 59-73); 55% were male, 76% White, 23% Black, 1.1% other races, insured by Medicare (51%), private payer (38%), Medicaid (8.3%), and self-pay/other (1.8%). In the multivariable models, self-pay/other payers (adjusted odds ratio [AOR], 0.15 [95% CI, 0.03 to 0.54]) was associated with lower odds of triplet or quadruplet regimen, compared with Medicare. Private insurance (AOR, 0.48 [95% CI, 0.27 to 0.86]) and self-pay/other payers (AOR, 0.16 [95% CI, 0.04 to 0.74]) had lower odds of lenalidomide. Black patients (v White; AOR, 0.47 [95% CI, 0.26 to 0.85]) and patients treated at regional hospitals (v Taussig Cancer Center; AOR, 0.27 [95% CI, 0.12 to 0.57]) had lower odds of SCT. The odds of receiving triplet or quadruplet regimen, lenalidomide, and SCT also varied by the year of NDMM. CONCLUSION Care for NDMM varied based on race, insurance type, year of diagnosis, and treatment facility. It may be useful to examine the impact of insurance-related characteristics and recent policy initiatives on care disparities. [ABSTRACT FROM AUTHOR]
- Subjects :
- STEM cell transplantation
MULTIPLE myeloma treatment
MULTIPLE myeloma diagnosis
COMBINATION drug therapy
PEARSON correlation (Statistics)
SOCIAL determinants of health
RESEARCH funding
HEALTH insurance
QUESTIONNAIRES
LOGISTIC regression analysis
FISHER exact test
KRUSKAL-Wallis Test
MEDICARE
CANCER patients
RETROSPECTIVE studies
DESCRIPTIVE statistics
MULTIVARIATE analysis
CHI-squared test
MANN Whitney U Test
LONGITUDINAL method
CARBOCYCLIC acids
ANTHROPOMETRY
DATA analysis software
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 26881527
- Volume :
- 20
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- JCO Oncology Practice
- Publication Type :
- Academic Journal
- Accession number :
- 177372156
- Full Text :
- https://doi.org/10.1200/OP.23.00672