Volume 50 | Number 1 | February 2015

Abstract List

Jean M. Mitchell Ph.D., Elizabeth A. Conklin M.P.P.


Objective

To identify factors that affect whether patients diagnosed with either leukemia or lymphoma receive a stem cell transplant and secondly if receipt of stem cell transplantation is linked to improved survival.


Data

California inpatient discharge records (2002–2003) for patients with either leukemia or lymphoma linked with vital statistics death records (2002–2005).


Study Design

Bivariate Probit treatment effects model that accounts for both the type of treatment received and survival while controlling for nonrandom selection due to unobservable factors.


Principal Findings

Having private insurance coverage and residence in a well‐educated county increased the chances a patient with either disease received . Increasing age and travel distance to the nearest transplant hospital had the opposite effect. Receipt of had a significant impact on mortality. We found the probability of death was 4.3 percentage points higher for leukemia patients who did have . Receipt of reduced the chances of dying by almost 50 percent. The likelihood of death among lymphoma patients who underwent was almost 5 percentage points lower, a 70 percent reduction in the probability of death.


Conclusions

The findings raise concern about access to expensive, but highly effective cancer treatments for patients with certain hematologic malignancies.