Interrupted Time-Series Analysis of Stereotactic Radiosurgery for Brain Metastases Before and After the Affordable Care Act.

Key findings were as follows: 1) There was an overall decline in radiation therapy utilization with an upward shift in utilization post-ACA; 2) Post-ACA, radiation therapy utilization shifted downwards for Northeastern and rural hospitals and upwards for certain categories of patients (females, 18-39 or ≥ 65 years of age, CCI≥10, non-elective admissions, Medicare, self-pay, no pay or other insurance) and hospitals (Midwestern, Western regions, urban (non-teaching)); 3) There was no clear overall trend in SRS utilization, although there was an increasing trend in SRS utilization among Hispanics, elective admission and rural hospitals; 4) Post-ACA, African-Americans and non-elective admissions experienced upward shift whereas elective admissions and rural hospitals experienced a downward shift in SRS utilization.

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