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How did exposure to Critical Access Hospitals change Medicare's effect on cancer survival?

Semprini, J.

2025-03-11 health economics
10.1101/2025.03.10.25323691 medRxiv
Show abstract

Upon turning 65, U.S. cancer patients experience the "Medicare Effect of better outcomes relative to patients nearly 65. Context likely mediates this effect, but so might differential access to care. With population-based cancer registry data, we construct a Difference-in-Discontinuities framework test if this "Medicare Effect" on cancer detection and survival varies in counties with and without a Critical Access Hospital (CAH), before and after CAH conversion. Consistent with prior literature, gaining Medicare was associated with reduced probability of distant stage diagnosis and improved two-year survival. Exposure to CAHs did not change Medicares effect on detection, but did increase Medicares effect on all-cause survival for males with prostate cancer (Est. = +0.019, se = 0.005), and females with lung (+0.046, se = 0.021) and colorectal cancer (Est. = +0.076, se = 0.026). Policies improving cancer survival remain warranted for both men and women with, and without Medicare.

Published in Cancer Causes & Control · not in our set (fewer than 10 published preprints to learn from) · training set

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