The Association Between Medical Insurance, Access to Care, and Outcomes for Patients with Uveal Melanoma in the United States.

Abstract

Purpose: To investigate the association between insurance status and uveal melanoma (UM) care.

Methods: We utilized the National Cancer Database to identify patients diagnosed with UM from 2004 to 2017. We examined the associations between patient sociodemographic characteristics, specifically insurance status, and UM care.

Results: Of 7677 patients, 50% had private, 41% Medicare, 4% Medicaid, 3% other government, and 3% no insurance. Most initially received brachytherapy (66%), followed by enucleation/resection (19%) and other treatment (15%). Compared to private, Medicaid and no insurance were associated with higher odds of late-stage disease presentation (p < .05). Patients with Medicare, Medicaid, and no insurance had higher odds of enucleation/resection and lower odds of brachytherapy versus enucleation/resection (p < .05 for all). Medicaid and no insurance were associated with lower odds of other treatment versus enucleation/resection (p < .05).

Conclusions: Access barriers to UM care may exist based on insurance status and may be associated with later-stage presentation and more radical treatment.