{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T07:10:39Z","timestamp":1767078639452,"version":"3.48.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Early and integrated palliative care (PC) interventions are recommended for advanced\u2010stage cancers. The rate with which patients with stage IV oral cavity squamous cell carcinoma (OCSCC) receive PC as part of their oncologic care is unknown. We sought to understand the utilization of PC for patients with stage IV OCSCC in Medicaid expanded versus non\u2010expanded states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>National Cancer Database was queried for patients with stage IV OCSCC from 2004 to 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients in Medicaid expanded (EXP) states were categorized as pre\u2010expansion (pre\u2010EXP) or post\u2010expansion (post\u2010EXP). Patients in nonexpanded states (NEXP) were categorized as diagnosed before 2014 (pre\u2010NEXP) or during\/after 2014 (post\u2010NEXP). Multivariable logistic regressions were used to compare receipt of PC among pre\u2010EXP and post\u2010EXP patients, and separately among post\u2010EXP and post\u2010NEXP cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 15,356 patients who met inclusion criteria, 629 (4.10%) received PC. There was a trend towards increased receipt of PC in post\u2010EXP compared to pre\u2010EXP cases, but this did not reach statistical significance. Among pre\u2010EXP and post\u2010EXP cases, patients were more likely to receive PC with the lowest income quartile, tongue cancer as the oral cavity subsite, and no insurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There was no significant difference of PC receipt for patients with stage IV OCSCC in Medicaid expanded versus non\u2010expanded states. Results among patients in pre\u2010EXP and post\u2010EXP states suggest increased PC use among more disadvantaged patient groups. Further analysis on receipt of PC in vulnerable patient populations with advanced\u2010stage cancer is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oto2.70184","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T20:50:34Z","timestamp":1763499034000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medicaid Expansion Status and Receipt of Palliative Care in Stage IV Oral Cavity Cancer"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4006-5437","authenticated-orcid":false,"given":"Rebecca S.","family":"Arch","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enver","family":"Ozer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine T.","family":"Haring","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen Y.","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nolan B.","family":"Seim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew O.","family":"Old","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James W.","family":"Rocco","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.1016\/j.oraloncology.2016.06.014"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1007\/s12663-016-0937-z"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1016\/S0278-2391(03)00149-6"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.6004\/jnccn.2021.0033"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1177\/1049909120983283"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.1001\/jamanetworkopen.2019.7136"},{"key":"e_1_2_8_8_1","article-title":"Implications of the ACA Medicaid expansion: a look at the data and evidence","author":"Rudowitz R","year":"2018","journal-title":"Henry J Kaiser Fam Found"},{"doi-asserted-by":"publisher","key":"e_1_2_8_9_1","DOI":"10.1093\/jnci\/djaa043"},{"doi-asserted-by":"publisher","key":"e_1_2_8_10_1","DOI":"10.1002\/cnr2.1840"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1002\/ohn.552"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1377\/hlthaff.2023.00035"},{"doi-asserted-by":"publisher","key":"e_1_2_8_13_1","DOI":"10.2217\/cer-2020-0178"},{"doi-asserted-by":"publisher","key":"e_1_2_8_14_1","DOI":"10.1245\/s10434-022-12563-4"},{"doi-asserted-by":"publisher","key":"e_1_2_8_15_1","DOI":"10.1016\/j.gassur.2024.01.042"},{"doi-asserted-by":"publisher","key":"e_1_2_8_16_1","DOI":"10.1002\/jso.26515"},{"doi-asserted-by":"publisher","key":"e_1_2_8_17_1","DOI":"10.1001\/jamaoto.2013.2549"},{"unstructured":"National Cancer Database.https:\/\/www.facs.org\/quality-programs\/cancer-programs\/national-cancer-database\/about\/. 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