Study Finds Medicare Patients Get Different Care
than People with Private Insurance
Study of over 40,000 kidney cancer patients shows
insurance coverage affects quality of care - docs take Medicare patient'
kidney out
April 27, 2009 – Doctors are much more likely to
remove the kidney of a senior citizen covered by Medicare than they are
other kidney cancer patients that happened to be covered by private
insurance. A new study of over 40,000 cases shows the private insurance
patients more likely to receive kidney-sparing surgery as their
treatment of renal malignancy. Researchers say it shows the disparity in
quality care.
According to researchers at Fox Chase Cancer
Center, insurance coverage may not only affect a patient's access to
health care, but also the quality of care they receive. Research
findings, presented yesterday at the American Urological Association's
Annual Meeting, may have implications for the national debate on
healthcare reform.
"We discovered a discrepancy in the type of
surgical treatment patients are offered based on their health
insurance," says Robert G. Uzzo, MD, chairman of the department of
surgery at Fox Chase and the study's lead author.
His research evaluated differences in surgical
treatment for kidney cancer based on a patient's health insurance
carrier. The study explored this question in one specific area of
medicine, but the results may have implications for other areas of
medicine as well.
The study results showed that kidney cancer
patients with Medicare as their primary payer 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 health care reform. This research
raises important questions for the government to consider," adds Uzzo.
"As our national leaders begin to discuss health
care reform, it will be important to keep in mind that who pays for the
care can affect the quality of care received."
Kidney cancer is commonly treated by surgically
removing the entire organ, but this is often unnecessary. Due to its
technical demands, however, kidney-sparing surgery remains widely
underutilized except at high-volume academic centers, where surgeons are
experienced not only in resection of very complex kidney tumors but also
in minimally-invasive techniques to treat patients with kidney cancer.
There are numerous long-term health benefits to
patients when the non-cancerous portion of the kidney can be preserved.
These include preserving maximum kidney function, reducing the risk of
dialysis down the road and a longer life expectancy.
Uzzo's 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.
Information Source (statement by source)
Fox Chase Cancer Center is one of the leading
cancer research and treatments centers in the United States. Founded in
1904 in Philadelphia as one of the nation's first cancer hospitals, Fox
Chase was also among the first institutions to be designated a National
Cancer Institute Comprehensive Cancer Center in 1974. Today, Fox Chase
conducts a broad array of nationally competitive basic, translational,
and clinical research, with special programs in cancer prevention,
detection, survivorship, and community outreach. For more information,
visit Fox Chase's web site at
www.fccc.edu or call 1-888-FOX-CHASE or 1-888-369-2427.
