Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals

You, Chang Hoon; Kang, Sung Gwon; Kwon, Young Dae; Choi, Jeong‐Yoon

doi:10.7314/apjcp.2013.14.11.6985

Cited by 19 publications

(21 citation statements)

References 16 publications

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“…Most inpatient spending occurred in that period as well. Regarding the impact of insurance coverage expansion policies, patients were more likely to use inpatient and outpatient services as coverage expanded, hence overall healthcare spending increased due to higher utilization in lung cancer patients (You et al, 2013). In Korea, there are no restrictions on using primary, secondary, and tertiary medical institutions, and no penalties for repeated care.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of increased cost-sharing on use of health services are well-documented, but the impact of expansion of insurance coverage on healthcare spending and utilizations is less researched (You et al, 2013). In the roughly 10 years since the policy was first implemented, there has been no comprehensive nationwide investigation into the effect of the coverage expansions.…”

Section: Introductionmentioning

confidence: 99%

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Copayment Policy Effects on Healthcare Spending and Utilization by Korean Lung Cancer Patients at End of Life: A Retrospective Cohort Design 2003-2012

Kim¹,

Han²,

Park³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Copayment Policy Effects on Healthcare Spending and Utilization by Korean Lung Cancer Patients at End of Life: A Retrospective Cohort Design 2003-2012

Kim¹,

Han²,

Park³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…The included studies were conducted in a range of countries but predominantly from USA: USA (14) [10][11][12][13][14][15][16][17][18][19][20][21][22][23], Singapore (1) [24], Korea (1) [25], Ireland (2) [26,27], Italy (1) [28], India (1) [7], Canada (2) [29,30], Australia (1) [31] and ASEAN nations (2) [6,32] (Table 1). The 25 studies covered 271,732 cancer survivors, with study samples ranging from 268 to 197,840.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…The 25 studies covered 271,732 cancer survivors, with study samples ranging from 268 to 197,840. Half the studies (14) included participants with any type of cancer [23,28,10,24,12,6,15,16,32,7,[20][21][22]25], 1 for adult onset cancers [17], 4 had a mix of 2-3 cancers (including breast and prostate cancers) [11,19,26,27], 2 breast cancer [14,30], 2 prostate cancer [29,31], and 2 blood cancers [13,18]. Eighteen studies (72%) were cross-sectional and the remainder were prospective or retrospective cohort studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

A Systematic Review of Financial Toxicity Among Cancer Survivors: We Can’t Pay the Co-Pay

Gordon

Merollini

Lowe

et al. 2016

Patient

377

331

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“…As a result, the Korean government has expanded health insurance coverage for cancer including decreasing out-of-pocket payments (Lee and Shaw, 2014;Kim and Kwon, 2015). The out-of-pocket expenditure on cancer has dropped around 30% and this number has been maintained from 2007 to 2010 (You et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Having Private Cancer Insurance in Korea: Gender Differences

Yoo

Noh²,

Kwon³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: As coverage of public insurance is not sufficient to cover diagnosis or treatment of cancer, having private health insurance is important to prepare for unexpected expenses of cancer. The purpose of this study was to assess factors associated with having private cancer insurance, considering gender among the sociodemographic factors and health behavior. Materials and Methods: We used data from the 2011 Korea Health Panel, which included 10,871 participants aged 20 years and older. Socio-demographics, health behavior, and perceived cancer risk were the independent variables and having private cancer insurance was the dependent variable. Multivariable logistic regression analysis was used to identify factors associated with having private cancer insurance. Results: The variables relating to middle age, higher education, higher household income, married men, and the perceived cancer risk groups of 1-10% and 11-30% were significantly associated with having private cancer insurance. Additionally, females who had private non-cancer health insurance were positively associated with the dependent variables (OR=1.36; 95% CI=1.17-1.57). Education, smoking status, exercise, and perceived cancer risk possibility were significantly associated with having private cancer insurance only among women. The men lowered the overall percentages of those having private cancer insurance (OR=0.53, 95% CI=0.45-0.63). Conclusions: We found that there were significant differences between men and women who had private cancer insurance. Women with private cancer insurance are more likely to follow precautionary health behavior than men. This could be interpreted as resulting from masculine ideologies. It is important to make males recognize the seriousness of the cancer risk. In general, household income was highly associated with private cancer insurance. These results reveal an inequity among the buyers of private cancer insurance in terms of economic status level, education level, and health condition.

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Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals

Cited by 19 publications

References 16 publications

Copayment Policy Effects on Healthcare Spending and Utilization by Korean Lung Cancer Patients at End of Life: A Retrospective Cohort Design 2003-2012

Copayment Policy Effects on Healthcare Spending and Utilization by Korean Lung Cancer Patients at End of Life: A Retrospective Cohort Design 2003-2012

A Systematic Review of Financial Toxicity Among Cancer Survivors: We Can’t Pay the Co-Pay

Having Private Cancer Insurance in Korea: Gender Differences

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