Health insurance status and survival among XXXX with head and neck cancer in Japan.

@entity1 @entity213
BACKGROUND: Healthcare systems vary among countries, and in many countries, insurance and economic statuses significantly impact the mortality associated with @entity213 ( @entity213 ). Japan prides itself on its unique healthcare and health insurance system, which provides equal coverage and healthcare access with low individual payments to most citizens. Additionally, citizens in poverty are covered by insurance for the poor (public assistance) and receive medical and other types of assistance. Hence, they have no barriers to healthcare services. This study aimed to determine the impact of health insurance status on mortality in Japanese @entity1 with @entity213 . METHODS: We reviewed 409 @entity1 with @entity213 , using the Kaplan-Meier method to estimate overall survival. The association between insurance status and disease stage at diagnosis was analyzed via logistic regression. Cox and Fine-Gray proportional hazard models were employed to investigate the impact of insurance status on survival. RESULTS: The public assistance and other insurances groups did not significantly differ in clinical stage distribution. The 5-year overall survival, cumulative incidence of @entity213 , and cumulative incidence of other death rates were 63.3 and 59.1  %, 27.0 and 31.8  %, and 10.3 and 9.7  % for the public assistance and other insurances groups, respectively. The adjusted  subdistribution hazard ratio for the association between public assistance and @entity213 was 0.73 (95  % confidence interval 0.44-1.21). CONCLUSIONS: The demonstrated non-inferiority of public assistance regarding @entity213 -specific mortality indicates the equality of healthcare in Japan, irrespective of the insurance status, and the superiority of the Japanese healthcare system.
