Pusan National University, South Korea.
Int J Health Serv. 2011;41(1):51-66. doi: 10.2190/HS.41.1.d.
This study explores income inequalities in the utilization of medical care by cancer patients in South Korea, according to type of medical facilities and survival duration. The five-year retrospective cohort study used data drawn from the Korean Cancer Registry, the National Health Insurance database, and the death database of the Korean National Statistical Office. The sample consisted of 43,433 patients diagnosed with cancer in 1999. The authors found significant quantitative inequalities as a function of income in the patients' utilization of medical care. Cancer patients from the highest income class used inpatient and outpatient care more frequently than did patients from the lowest income class. Those with higher incomes tended to use more inpatient and outpatient services at major tertiary hospitals, which were known as providing better medical care than other types of hospitals and clinics. Moreover, horizontal inequality in cancer-care expenditures favoring those with higher incomes was observed during earlier periods of treatment. In conclusion, income substantially affects the utilization of inpatient and outpatient services, amount of medical expenditures, and type of medical facilities.
本研究探讨了韩国癌症患者根据医疗设施类型和生存时间的不同,在医疗保健利用方面的收入不平等情况。这项回顾性的五年队列研究使用了来自韩国癌症登记处、国家健康保险数据库和韩国国家统计局死亡数据库的数据。样本包括 1999 年诊断出患有癌症的 43433 名患者。研究人员发现,患者医疗保健利用方面的收入存在显著的数量不平等。来自最高收入阶层的癌症患者比来自最低收入阶层的患者更频繁地使用住院和门诊治疗。收入较高的人往往更倾向于在大型三级医院使用更多的住院和门诊服务,因为这些医院被认为提供的医疗服务比其他类型的医院和诊所更好。此外,在治疗的早期阶段,还观察到了有利于高收入人群的癌症治疗支出的水平不平等。总之,收入会显著影响住院和门诊服务的利用、医疗支出的多少以及医疗设施的类型。