Acknowledging Insurance-Mediated Disparities in Gynecologic Cancers


Anna Jo Bodurtha Smith, MD, discusses background on her research regarding insurance-mediated disparities in gynecologic oncology.

Anna Jo Bodurtha Smith, MD, a third year Gynecologic Oncology fellow at the University of Pennsylvania, fellow at the Penn Center for Cancer Care Innovation and Leonard Davis Institute of Health Economics, discusses background on her research regarding insurance-mediated disparities in gynecologic oncology.

Smith explains that she was inspired to learn more about the effects various insurance types have on the quality of care of patients with gynecologic cancer based on her prior research in this space, as well as her own personal experiences.


0:08 | It's both based on my prior research, as well as my own personal family experience. Starting with the family experience, my grandfather got diagnosed with cancer when he was around [my current age]. This was prior to us having a lot of the health programs we have now, prior to Medicaid, prior to Medicare, etc., and he and my mom lost everything. They lost their insurance; they ended up paying for everything out of pocket and it is sort of the formative family story we have about what happens when you get cancer and don't have insurance.

0:45 | That spurred my early interest in insurance and starting in college, I've worked since then on how insurance impacts health care outcomes. More recently as an OBGYN resident, I finished my medical training around the time of the Affordable Care Act and was very interested on how the Affordable Care Act could impact patients with gynecologic cancer. Much of my research that preceded this article was around the fact that the insurance gain under the Affordable Care Act did lead to earlier stage diagnosis, earlier access to care, and we were publishing data that improves survival. Insurance really does matter for patients with gynecologic cancer.

1:26 | What we talk about a lot is whether having insurance or not matters. We know that patients who are uninsured are less likely to get screening, which for cervical cancer, breast cancer, or colorectal cancer, is so important. They're more likely to delay presentation to care and ultimately diagnosed with late stage less likely to be cured.

1:47 | What I was interested in in this article, which sort of had been spurred by my research on the Affordable Care Act, is what happens when patients are insured, but their insurance isn't enough? Or there's something we call underinsured meaning they either struggle to afford care with their insurance, they aren't able to access it with their insurance, or it's not available with their insurance. We specifically looked at each of those stages for Medicaid, Medicare, and private insurance and looked at where the barriers were.

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