Effect of the Affordable Care Act on breast cancer presentation at a safety net hospital.
INTRODUCTION
The Affordable Care Act (ACA) mandated the expansion of Medicaid in order to increase access to health care services. We examined the effect of the ACA on breast cancer screening and diagnosis at a Los Angeles safety net hospital.


METHODS
We performed a retrospective review of breast cancer patients treated at our institution. We compared two cohorts: patients diagnosed with breast cancer in the years 2011-2012 (pre-ACA) vs. 2015-2016 (post-ACA).


RESULTS
There were no differences in number of screening mammograms performed, age at diagnosis, mammography-detected cancers, or clinical stage at diagnosis. There was a significant decrease in the number of patients who reported as self-pay (34% vs. 6%, p < 0.0001).


CONCLUSION
In the 2-year period following ACA implementation, there was limited impact on breast cancer presentation at a safety-net hospital. Long-term follow-up across different healthcare systems is necessary to fully evaluate the global impact of the ACA on breast cancer care.
['Satyananda|Vikas|V|', 'Ozao-Choy|Junko|J|', 'Dauphine|Christine|C|', 'Chen|Kathryn T|KT|']
D001943:Breast Neoplasms D005260:Female D054625:Healthcare Disparities D006801:Humans D019458:Insurance Coverage D008327:Mammography D008484:Medicaid D008875:Middle Aged D058991:Patient Protection and Affordable Care Act D012189:Retrospective Studies D064876:Safety-net Providers D014481:United States
Affordable Care Act Breast cancer Safety-net hospital Health disparities