Factors Affecting Stem Cell Transplantation for Leukemia and Lymphoma
Although hematopoietic stem cell transplantation (HSCT) may provide the best available treatment for certain types of leukemia and lymphoma, health care inflation and the rising number of the uninsured raise concerns about access to such expensive medical technologies. This study examines the effect of socioeconomic characteristics, insurance coverage, hospital characteristics, and health status on access to HSCT for leukemia and lymphoma patients. It analyzes Arizona hospital discharge data from 1997 to 2003 using a linear probability model corrected for heteroskedasticity. The findings show that individuals with less generous insurance coverage are significantly less likely to receive a HSCT relative to individuals with private commercial insurance. Hospital characteristics, patient disease type, and patient comorbidities all have significant effects on patient access to HSCT. Surprisingly, race does not have a significant influence on HSCT use. Taken within the context of the rising number of uninsured, these findings point to the need for policy to address the problems of uninsurance and underinsurance as barriers to timely and appropriate medical care in the United States.
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Chen, Jonathan M.; Weinberg, Alan D.; Rose, Eric A.; Thompson, Seth M.; Mancini, Donna M.; Ellison, June P.; Reemtsma, Keith; Michler, Robert E. (1996-02)