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[私人健康保险对韩国癌症患者医疗服务利用和支出的影响:聚焦于某癌症中心的5种主要癌症]

[Effects of private health insurance on health care utilization and expenditures in Korean cancer patients: focused on 5 major cancers in one cancer center].

作者信息

Lim Jin Hwa, Choi Kui Son, Kim Sung Gyeong, Park Eun-Cheol, Park Jae Hyun

机构信息

National Cancer Control Research Institute, National Cancer Center, Korea.

出版信息

J Prev Med Public Health. 2007 Jul;40(4):329-35. doi: 10.3961/jpmph.2007.40.4.329.

Abstract

OBJECTIVES

To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea.

METHODS

The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis.

RESULTS

Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits.

CONCLUSIONS

We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

摘要

目的

确定补充性私人健康保险对韩国强制性国民健康保险(NHI)体系下医疗保健利用和支出的影响。

方法

数据由韩国国立癌症中心收集。新诊断为胃癌(国际疾病分类代码,C16)、肺癌(C33 - C34)、肝癌(C22)、结直肠癌(C18 - C20)或乳腺癌(C50)的癌症患者被纳入作为研究对象。通过面对面访谈使用结构化问卷、医院医嘱通信系统(OCS)和医疗记录收集数据。还收集了临床、社会人口统计学和私人健康保险相关因素。使用t检验和多变量回归分析比较有私人健康保险者和无私人健康保险者在医疗保健利用和支出方面的差异。

结果

有私人健康保险的个体住院费用高于没有私人健康保险的个体,但在其他服务利用方面未发现差异,如住院次数、住院天数和就诊次数。

结论

我们发现私人健康保险对住院服务的医疗保健支出有显著影响。这些研究结果可为制定有关私人健康保险的国家卫生政策提供合理依据。需要进一步研究来调查私人健康保险对癌症患者结局和生存率的影响。

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