Gastric cancer survival and affiliation to health insurance in a middle-income setting

摘要: Abstract Objective To investigate whether health insurance affiliation and socioeconomic deprivation is associated with overall cause survival from gastric cancer in a middle-income country. Methods All patients resident the Bucaramanga metropolitan area (Colombia) diagnosed between 2003 2009 ( n =1039), identified population-based registry, were followed for vital status until 31/12/2013. Kaplan–Meier models provided crude estimates by regime (HIR) social stratum (SS). Multivariate Cox-proportional hazard adjusting HIR SS sex, age tumor grade, performed. Results Overall 1 5 year proportions 32.4% 11.0%, respectively, varying 49.3% 15.8% affiliated to most generous 12.9% 5.3% unaffiliated patients, 41.4% 20.7% highest SS, versus 27.1% 7.4% lowest SS. The multivariate analyses showed type of as well remain independently survival, an 11% improvement each increase subgroup (HR 0.89 (95% CI 0.83; 0.96), worse subsidized (least generous) compared contributory 1.20 1.00; 1.43) HR not 2.03 1.48; 2.78)). Of non-affiliated 60% had died at time diagnosis, 4–14% p Conclusions Despite ‘universal' system, large differences exist Colombia. Both access effective diagnostic curative care strongly influence survival.