Abstract：
INTRODUCTION:The Affordable Care Act (ACA) expanded Medicaid eligibility to persons with income up to 138% of the federal poverty line. We investigated how Medicaid expansion (ME) impacted the access to cancer-specific surgical care in the US. METHODS:We used a nationwide population-based database (SEER) to identify patients with the 8 most prevalent cancers between 2007 and 2015. Adjusted difference-in-differences (DiD) and multivariate regression were used for statistical analysis. RESULTS:A total of 1,008,074 patients were included. Patients post-ME were diagnosed at an earlier stage (pre-ME, 27.6%; post-ME, 31.1%; P < 0.001), and lack of insurance coverage decreased from 5.5% to 2.6% (P < 0.001). Lower-SES population had improved access to surgical care (attributable benefit +3.18%; P < 0.001). ME was an independent predictor of access-to-surgery (OR, 1.45; P < 0.001), whereas African-American and Hispanic race were negative predictive factors. CONCLUSION:After ME, the population without insurance coverage decreased. This was associated with earlier cancer diagnosis and improved access to surgery in patients from economically disadvantaged communities.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Mesquita-Neto JWB,Cmorej P,Mouzaihem H,Weaver D,Kim S,Macedo FIdoi
10.1016/j.amjsurg.2019.06.023subject
Has Abstractpub_date
2020-01-01 00:00:00pages
181-184issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(19)30688-9journal_volume
219pub_type
杂志文章abstract：:The mesocaval graft for portal decompression is applicable in infants and children with portal hypertension secondary to extrahepatic or intrahepatic causes. It is recommended in patients in whom extensive previous surgery in the portahepatis (Kasai procedure) would make dissection of the portal vein difficult and end...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90011-9
更新日期：1978-01-01 00:00:00
abstract：BACKGROUND:The use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown. METHODS:The Nationwide Inpatient Sample was queried for colorectal resections performed for diverticulitis during emergent hospital admissions (2003-2007). Univariate and multivariate analyses ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.01.004
更新日期：2012-05-01 00:00:00
abstract：:The presentation, surgical management, and clinical outcome in 153 patients with biliary pancreatitis has been reviewed. Only 37 percent of our patients demonstrated any of Ranson's 11 prognostic signs of severe pancreatitis, and only 3 percent had 3 or more signs. Fourteen patients underwent emergency operation withi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90028-0
更新日期：1986-01-01 00:00:00
abstract：:A new, improved drainage system has been specifically designed to provide either closed suction drainage for the ambulating patient or sump drainage for the patient confined to bed. This drainage system is made of silicone that has a hydrogel coating with a low coefficient of friction. This coating facilitates removal...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80089-1
更新日期：1985-02-01 00:00:00
abstract：:Esophageal transection with the EEA stapler was performed in five patients with bleeding esophageal varices. Bleeding from varices has not recurred in surviving patients during follow-up of up to 27 months. One death occurred during the postoperative period. Esophageal transection with the EEA stapler is an effective ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90125-7
更新日期：1980-12-01 00:00:00
abstract：BACKGROUND:This study characterizes the gastrointestinal (GI) microbiome in a pre-clinical polytrauma hemorrhage model. METHODS:Rats (n = 6) were anesthetized, hemorrhaged 20% of their blood volume, and subjected to a femur fracture and crush injuries to the small intestine, liver, and limb skeletal muscle without res...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.026
更新日期：2018-10-01 00:00:00
abstract：:In a multicenter prospective, randomized study, the efficacy of a single preoperative dose of 1 g of cefotaxime for avoiding wound infections was compared with four 2-g doses of cefoxitin. In the study, 1,451 patients with infection risk factors who underwent gastroduodenal or biliary surgery were included, of whom 72...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/0002-9610(89)90278-x
更新日期：1989-11-01 00:00:00
abstract：BACKGROUND:The aim of this study was to identify patient-related and/or disease-related factors that influence outcomes in patients with vascular prosthetic graft infections. METHODS:Through the hospital patient administration system, between January 1997 and December 2007, a total of 44 patients were diagnosed with c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.05.018
更新日期：2010-07-01 00:00:00
abstract：:The dose response curves for acid and pepsin output to increasing intravenous doses of pentagastrin (0.01, 0.02, 2, 8, and 16 micrograms/kg per hour) were determined in six male patients with duodenal ulcer and six with type 1 corporeal gastric ulcer before and 3 to 6 months after selective proximal vagotomy and excis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90433-7
更新日期：1985-11-01 00:00:00
abstract：:The type of endorectal pull-through described by Black was evaluated as an alternative method of anastomosis in 11 anterior resections in which anastomosis from above was impossible. The method is attractive from the standpoint of function because it preserves the distal rectum and leaves the anus intact. Technical po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90249-6
更新日期：1979-07-01 00:00:00
abstract：BACKGROUND:Advantages of laparoscopic cholecystectomy (LC) such as less pain and short hospital stay make it the treatment of choice for cholelithiasis. There are limited data about LC under spinal anesthesia. This study was designed to evaluate LC under spinal anesthesia. METHODS:Twenty-nine patients underwent surger...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2007.05.043
更新日期：2008-04-01 00:00:00
abstract：BACKGROUND:We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures. METHODS:Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fract...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.040
更新日期：2007-12-01 00:00:00
abstract：:Between 1968 and 1979, 183 patients with invasive epidermoid cancer of the anal canal were treated at Institut Curie. There was 156 women, 27 men with a mean age of 67 +/- 11 years (range 40 to 85 years). The initial height of the tumor was less than 4 cm (65 patients), 4 to 6 cm (98 patients), and more than 6 cm (20 ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90032-1
更新日期：1984-01-01 00:00:00
abstract：:Twenty-six patients with advanced melanoma metastases confined to the lower extremity underwent 28 therapeutic limb perfusions without a major complication or treatment-related death. A complete response to treatment occurred in 21 patients (81 percent). Of 16 patients, response persisted until death in 13 and was not...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90006-6
更新日期：1985-07-01 00:00:00
abstract：BACKGROUND:The aim of this study was to evaluate the incidence of severe complications of adult inguinal hernia surgery from 2003 to 2007 using data from the Finnish National Patient Insurance Association. METHODS:All major surgical complications are reported to the association because it handles financial compensatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.04.018
更新日期：2010-06-01 00:00:00
abstract：:A biochemical analysis of mitochondrial metabolism was made on biopsy specimens of fifteen jaundiced patients. In all but three jaundiced patients the phosphorylative activity based on mitochondrial protein was within normal limits or higher. In nine jaundiced patients the concentrations of cytochrome a(+a3), as repre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90534-7
更新日期：1977-03-01 00:00:00
abstract：:Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail. Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis. System...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90397-0
更新日期：1979-08-01 00:00:00
abstract：:Most series dealing with external gastrointestinal fistulas cover experience of many years and include a heterogeneous sample of fistulas. We present our experience with 117 cases of postoperative external alimentary tract fistulas treated since 1980. Only fistulas caused by anastomotic leaks and operative injury to b...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)91107-t
更新日期：1991-04-01 00:00:00
abstract：:Dissatisfaction with time-consuming double layer anastomoses in intestinal surgery and with occasionally questionable stapled anastomoses prompted a review of available techniques for hand sewn suture lines. Single layer anastomoses have been used extensively and their integrity and safety have often been questioned. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80189-6
更新日期：1985-06-01 00:00:00
abstract：:Two patients with coexisting neurofibromatosis and hyperparathyroidism are described, bringing the total number of such cases in the world literature to seven. Other more classic examples of the association of tumorous conditions of neuroectodermal and entodermal origin are discussed to support the suggestion that the...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90079-5
更新日期：1979-03-01 00:00:00
abstract：:Familial visceral myopathy is a form of chronic intestinal pseudoobstruction in which fibrosis of the smooth muscle of the alimentary tract causes protean symptoms of disordered visceral motility. Based on our 8 year observation of six members of one family with familial visceral myopathy and review of the few well-do...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90017-0
更新日期：1985-07-01 00:00:00
abstract：BACKGROUND:Because of the increase in the geriatric population, an increasing number of elderly patients are being treated for colorectal cancer. The purpose of this study was to evaluate perioperative morbidity and mortality in this population. METHODS:A retrospective chart review was performed for patients 80 years ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.12.022
更新日期：2008-03-01 00:00:00
abstract：:The efficacy of photodynamic therapy tumor destruction is dependent upon both the interruption of the tumor vasculature and the resultant production of unstable oxygen species causing cellular oxidation and death. Chloroaluminum sulfonated phthalocyanine (CASP) is a recently developed photosensitizer. In order to stud...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80543-4
更新日期：1990-10-01 00:00:00
abstract：:We have tested the interaction between serotonin and secretin in pentagastrin-induced gastric acid secretion in six dogs prepared with Thomas gastric and duodenal cannulas. We further examined the effect of methysergide, a serotonin antagonist, on gastric acid secretion. The intravenous administration of serotonin or ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80007-6
更新日期：1985-01-01 00:00:00
abstract：:We have found that the venous pressure slope during minimal exercise is a sensitive measurement of venous disease. This parameter differed greatly in our two study populations. Due to increased venous pressure, venous insufficiency syndrome patients have a greater volume of pooled blood, which results in smaller press...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90120-5
更新日期：1985-08-01 00:00:00
abstract：:The portal-superior mesenteric vein (PV/SMV) is occasionally involved by a microscopic level of cancer invasion from pancreatic cancer even when it seems to be intact by a macroscopic inspection during surgery. Therefore, contact endoscopy, with which a high-magnification image of the methylene blue-stained PV/SMV wal...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.03.009
更新日期：2009-11-01 00:00:00
abstract：:Chronic anal fissure is the main cause of anal pain and is very common. Many treatment modalities have been tried-none is ideal. Recently, topical nitric oxide releasing agents and botulin toxin injections have been used, trying to replace surgery. No long-term experience is available. Personal experience with 2,108 o...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00307-x
更新日期：2000-03-01 00:00:00
abstract：:Between July 1973 and October 1984, we performed proctectomy either as part of a primary proctocolectomy or as a secondary staged procedure in 388 patients with ulcerative colitis and in 39 patients with Crohn's disease. The proctectomies were performed using a two-team synchronous approach. An intersphincteric or per...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90026-7
更新日期：1986-01-01 00:00:00
abstract：:Recurrence of hyperparathyroidism after initially successful primary operation is usually caused by inadequate resection of diseased tissue or recurrent carcinoma. Since it is known that normal parathyroid tissue may be autotransplanted into a muscle bed, it is plausible that inadvertent implantation of parathyroid ti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80178-1
更新日期：1985-06-01 00:00:00
abstract：:During a fourteen year period, diagnostic peritoneal lavage was 98.5 per cent accurate in determining the presence or absence of blunt intraabdominal injuries among 2,586 patients. Of these, 69.4 per cent had a negative lavage and 29.2 per cent a positive lavage. Six patients (0.2 per cent) had a false-positive lavage...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90339-2
更新日期：1978-12-01 00:00:00
