UNASSIGNED: 243 Background: This study compares the average stage of diagnosis for @entity320 by insurance status and household income. This is the largest such study for @entity320 to date. METHODS: Using the National @entity5 Database (NCDB) we examined 299,214 @entity1 with @entity320 between 2000 and 2009 at 1,408 hospitals. The relationship of average stage of diagnosis is compared across insurance types and by income for 293,438 @entity1 . RESULTS: The VAH @entity1 population had the lowest average stage of diagnosis (0.89) with the Medicaid population exhibiting the highest (1.87, p<0.0001). The VAH was lower than Tricare which had an average diagnosis of 1.11 (p<0.0001), private insurance 1.20 (p<0.0001), Medicare 1.34 (p<0.0001), and uninsured 1.70 (p<0.0001). The lowest rate of stage IV was private insurance (3.31%), with Tricare at 3.67% (p<0.0001), VAH 4.46% (p<0.0001), Medicare 5.74% (p<0.01), uninsured 10.12% (p<0.0001), and the highest rate was among Medicaid (14.35%, p<0.0001). The highest income category (>=  49K) had the lowest average stage at diagnosis of 1.16 compared to  39K to  48K (1.28, p<0.0001),  33K to  38K (1.35, p<0.0001),  28K to  32K (1.40, p<0.0001), and the lowest income group (< 28K) had the highest average stage of diagnosis (1.46, p<0.0001). The rate of Stage IV diagnosis increased from the highest income group (3.68%), followed by  39K to  48K (4.69%, p<0.0001),  33K to  38K (5.17%, p<0.0001),  28K to  32K (5.89%, p<0.0001), and less than  28K (6.92%, p<0.0001). CONCLUSIONS: Overall, VAH @entity1 , higher income @entity1 and @entity1 with private insurance were diagnosed with earlier stage @entity320 as compared to those with no insurance and Medicaid, who were more frequently diagnosed with stage IV disease. The VAH provision of high quality care, particularly preventative care, can result in improved @entity1 outcomes such as @entity5 survival (Landrum et al, 2012). Reference: Landrum MB, Keating NL, Lamont EB, et al. Survival of Older @entity1 with @entity5 in the Veterans Health Administration versus Fee-for-Service Medicare. Journal of Clinical Oncology, April 2012, 30(10): 1072-1079.

Analysis of stage of XXXX diagnosis in relation to insurance type and income as an indicator of early/late diagnosis.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'Cancer'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma']
@entity320 :: (MESH:D008545,Disease) :: ['melanoma']
