Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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National Statistics of Endoscopic Submucosal Dissection for Early Gastric Cancer in Korea

  • Sang Hoon Lee (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Hyunseok Cho (Department of Pediatrics, Kangwon National University School of Medicine) ;
  • Myoung-Nam Lim (Biomedical Research Institute, Kangwon National University Hospital) ;
  • Seung-Joo Nam (Department of Internal Medicine, Kangwon National University School of Medicine)
  • Received : 2024.06.02
  • Accepted : 2024.09.20
  • Published : 2024.10.01
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Abstract

Purpose: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis. In Korea, ESD was included in the National Health Insurance (NHI) coverage in 2011, which was expanded in 2018. In the present study, we investigated the status and trends of ESD for EGC over the past decade since its incorporation into the NHI system. Materials and Methods: We analyzed the data from the National Health Insurance Service (NHIS) database from 2011 to 2021, focusing on patient characteristics, number of ESD procedures, in-hospital length of stay (LOS), and total medical cost (TMC) per admission. In addition, we conducted an interrupted time series analysis to assess the impact of changes in insurance coverage on these variables. Results: Overall, 95,348 cases of ESD for EGC were identified. A consistent annual increase in ESD procedures was observed, particularly in tertiary care hospitals and among patients aged >60 years. The overall median LOS and TMC were 4 days and 2,123,000 KRW, respectively. The 2018 insurance coverage expansion did not significantly affect the number of ESD procedures or LOS; however, the TMC increased significantly. Conclusions: Our study illustrates decade-long trends in the ESD for EGC in Korea. The policy needs to be revised continuously to optimize ESD use and improve resource allocation within healthcare systems.

Keywords

Acknowledgement

We would like to thank Dongwoo Kang and Jungkuk Lee of the data science team at Hanmi Pharmaceutical Co., Ltd. for processing the data and providing statistical consultation.

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