The Effect of Expanding Health Insurance Benefits for Cancer Patients on the Equity in Health Care Utilization

건강보험 암 중증질환 급여확대가 의료이용 형평성에 미친 영향

  • Kim, Su-jin (Graduate School of Public Health, Seoul National University) ;
  • Ko, Young (National Health Insurance Corporation) ;
  • Oh, Ju-Hwan (Graduate School of Public Health, Seoul National University) ;
  • Kwon, Soon-Man (Graduate School of Public Health, Seoul National University)
  • 김수진 (서울대학교보건대학원) ;
  • 고영 (국민건강보험공단) ;
  • 오주환 (서울대학교보건대학원) ;
  • 권순만 (서울대학교보건대학원)
  • Published : 2008.09.30


Government has extended the benefit coverage and reduced out-of-pocket (OOP) payment for cancer patients in 2005. This paper intends to examine the impact of the above policy on the equity in health care utilization. This paper analyzed the national health insurance data and compared the health care utilization of cancer patients before and after the policy change for people with 10 different income levels. For the equity in health care utilization, we examined the change in concentration index (CI) for visit days, inpatient days, and health expenditure. In the case of outpatient care, CI of visit days and health expenditure were positive(favoring the rich) in both regional and employee health insurance members and both 'before' and 'after' the policy change. CI values rarely changed after the policy change, and the policy change seems to have little impact on the equity of outpatient care utilization except expenditure of regional subscriber. In the case of inpatient care, CI of inpatient days was negative and CI of health expenditure was positive in both regional and work subscriber and both 'before' and 'after' the policy change. After the policy change, CI of inpatient expenditure in both groups of members decreased. CI of inpatient days changed in the direction favoring the poor in regional insurance members, but it rarely changed in employee insurance members. These results suggest that the policy of reducing OOP payment has a positive impact and reduced the inequity particularly in the utilization of inpatient care of cancer patients.


Cancer;Benefit coverage;Equity;Health care


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