- Volume 14 Issue 11
DOI QR Code
Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals
- You, Chang Hoon (Yonsei Business Research Institute and School of Business, Yonsei University) ;
- Kang, Sungwook (Department of Public Health, Daegu Haany University) ;
- Kwon, Young Dae (Department of Medical Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management) ;
- Choi, Ji Heon (Department of Public Health, Graduate School, The Catholic University of Korea)
- Published : 2013.11.30
Background: This study aimed to examine out-of-pocket expenditure for cancer treatments of hospitalized patients and to analyze changing patterns over time. Materials and Methods: This study examined data of all cancer patients receiving inpatient care from two tertiary hospitals from January 2003 to December 2010. Medical expenditures per admission were calculated and classified into those covered and uncovered by the Korean National Health Insurance (NHI) and co-payment. Results: The medical expenditure per admission increased slowly from 3,455 thousand Korean won (KRW) to 4,068 thousand KRW. While expenditures covered by the NHI have increased annually, co-payments have generally decreased. The out-of-pocket expenditure ratio, which means the proportion of uncovered expenditure and co-payment among total medical expenditure dropped sharply from 2005 to 2007 and was maintained at a similar level after 2007. Medical expenditures, NHI coverage, and the out-of-pocket expenditure ratio differed across cancer types. Conclusions: It is necessary to continually monitor the expenditure of uncovered services by the NHI, and to provide policies to reduce this economic burden. In addition, an individual approach considering cancer type-specific characteristics and medical utilization should be provided.
Hospitalization;medical expenditure;neoplasm type;out-of-pocket expenditure;trends
- Bae JY (2010). Impacts of health insurance coverage expansion on health care utilization and health status. Korean J Soc Welf Study, 41, 35-65. https://doi.org/10.16999/kasws.2010.41.2.35
- Choi YS, Lee KO, Yim ES (2011). Factors affecting perceived financial burden of medical expenditures. J Korean Acad Nurs Adm, 17, 147-57. https://doi.org/10.11111/jkana.2011.17.2.147
- Jonsson B, Wilking N (2007). The burden and cost of cancer. Ann Oncol, 18, 8-22.
- Jung KW, Park S, Kong HJ, et al (2012). Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2009. Cancer Res Treat, 44, 11-24. https://doi.org/10.4143/crt.2012.44.1.11
- Kim CB, Lee DS, Kim HJ, et al (1995). Empirical analysis of price elasticity of the demand for medical care services in Korean National Health Insurance program. Korean J Prev Med, 28, 450-61.
- Kim P (2007). Cost of cancer care: the patient perspective. J Clin Oncol, 25, 228-32. https://doi.org/10.1200/JCO.2006.07.9111
- Kim SJ, Ko Y, Oh JH, et al (2008). The effect of expanding health insurance benefits for cancer patients on the equity in health care utilization. Korean J Health Policy Adm, 18, 90-109. https://doi.org/10.4332/KJHPA.2008.18.3.090
- Kim SG, Hahm MI, Choi KS, et al (2008). The economic burden of cancer in Korea in 2002. Eur J Cancer Care, 17, 136-44. https://doi.org/10.1111/j.1365-2354.2007.00818.x
- Kim H, Jang J, Sohn HS (2012). Anticancer drug use and out-of-pocket money burden in Korean cancer patients: a questionnaire study. Korean J Clin Pharm, 22, 239-50.
- Kimman M, Norman R, Jan S, et al (2012). The burden of cancer in member countries of the association of Southeast Asian Nations (ASEAN). Asian Pac J Cancer Prev, 13, 411-20. https://doi.org/10.7314/APJCP.2012.13.2.411
- Langa KM, Fendrick AM, Chernew ME, et al (2004). Out-of-pocket health-care expenditures among older Americans with cancer. Value Health, 7, 186-94. https://doi.org/10.1111/j.1524-4733.2004.72334.x
- Lee YJ (2009). A study on the influences of changes to the co-payment of cancer patients of their uses of medical services. Korean J Public Policy, 11, 3-25.
- Mariotto AB, Robin Yabroff K, Shao Y, et al (2011). Projections of the cost of cancer care in the United States: 2010 patie. J Natl Cancer Inst, 103, 117-28. https://doi.org/10.1093/jnci/djq495
- Mathews M, West R, Buehler S (2009). How important are out-of-pocket costs to rural patients' cancer care decisions? Can J Rural Med, 14, 54-60.
- Neumann PJ, Palmer JA, Nadler E, et al (2010). Cancer therapy costs influence treatment: a national survey of oncologists. Health Aff (Millwood), 29, 196-202. https://doi.org/10.1377/hlthaff.2009.0077
- Norton EC, van Houtven CH, Lindrooth RC, et al (2002). Does prospective payment reduce inpatient length of stay? Health Econ, 11, 377-87. https://doi.org/10.1002/hec.675
- Penberthy L, Retchin SM, McDonald MK, et al (1999). Predictors of Medicare costs in elderly beneficiaries with breast, colorectal, lung, or prostate cancer. Health Care Manag Sci, 2, 149-60. https://doi.org/10.1023/A:1019096030306
- Shin JY, Kim SY, Lee K-S, et al (2012). Costs during the first five years following cancer diagnosis in Korea. Asian Pac J Cancer Prev, 13, 3767-72. https://doi.org/10.7314/APJCP.2012.13.8.3767
- Wagner L, Lacey MD (2004). An overview with implications and referral resources for oncology nurses. Clin J Oncol Nurs, 8, 279-87. https://doi.org/10.1188/04.CJON.279-287
- Warren JL, Yabroff KR, Meekins A, et al (2008). Evaluation of trends in the cost of initial cancer treatment. J Natl Cancer Inst, 100, 888-97. https://doi.org/10.1093/jnci/djn175
- Yabroff KR, Davis WW, Lamont EB, et al (2007). Patient time costs associated with cancer care. J Natl Cancer Inst, 99, 14-23. https://doi.org/10.1093/jnci/djk001
- Copayment Policy Effects on Healthcare Spending and Utilization by Korean Lung Cancer Patients at End of Life: A Retrospective Cohort Design 2003-2012 vol.15, pp.13, 2014, https://doi.org/10.7314/APJCP.2014.15.13.5265
- Having Private Cancer Insurance in Korea: Gender Differences vol.16, pp.17, 2015, https://doi.org/10.7314/APJCP.2015.16.17.7981
- The Economic Burden of Cancer in Korea in 2009 vol.16, pp.3, 2015, https://doi.org/10.7314/APJCP.2015.16.3.1295
- The Health Examinees (HEXA) Study: Rationale, Study Design and Baseline Characteristics vol.16, pp.4, 2015, https://doi.org/10.7314/APJCP.2015.16.4.1591
- Treatment interruption during radiation therapy: Experience at a single institution in the Republic of Korea vol.13, pp.5, 2016, https://doi.org/10.1111/ajco.12572
- A Systematic Review of Financial Toxicity Among Cancer Survivors: We Can’t Pay the Co-Pay vol.10, pp.3, 2017, https://doi.org/10.1007/s40271-016-0204-x
- Factors of hospitalization expenditure of the genitourinary system diseases in the aged based on “System of Health Account 2011” and neural network model vol.8, pp.2, 2018, https://doi.org/10.7189/jogh.08.020504