Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Korea.
Gut Liver. 2020 Jan 15;14(1):108-116. doi: 10.5009/gnl18522.
The National Liver Cancer Surveillance Program (NLCSP) was established in 2003 to reduce the socioeconomic burden imposed by liver cancer (LC). We aimed to investigate the effectiveness of the NLCSP in South Korea with respect to survival benefits and cost, after adjusting for various confounding factors. We used the National Health Insurance Service claims data linked with the NLCSP from 2004 to 2015. The Cox proportional hazard model and generalized linear model were used to determine the effects of the NLCSP on the early detection of LC, survival, and medical costs. From 2006 to 2010, 66,632 patients (surveillance group: 10,527 and no surveillance group: 56,105) newly diagnosed with LC were included in the study. The odds of the early detection of LC was 1.82 (95% confidence interval [CI], 1.73 to 1.93) times higher among patients who participated in the NLCSP once within the 2-year period prior to the diagnosis of LC than among those who did not participate in the surveillance program. The mortality rate of patients who participated in the NLCSP was 22.0% lower (hazard ratio, 0.78; 95% CI, 0.76 to 0.80) than that of those who did not participate. When compared with the group who did not participate in surveillance, the group who participated in the NLCSP had higher total medical costs; however, their cost per day was lower after adjustment during the follow-up period. This study highlights the survival benefit in patients who participated in the NLCSP and the need for continuous improvements of the NLCSP in South Korea.
国家肝癌监测计划（NLCSP）成立于 2003 年，旨在减轻肝癌（LC）给社会经济带来的负担。我们旨在通过调整各种混杂因素，研究 NLCSP 在韩国的生存获益和成本效果。我们使用了 2004 年至 2015 年国家健康保险服务索赔数据与 NLCSP 进行了链接。Cox 比例风险模型和广义线性模型用于确定 NLCSP 对 LC 早期检测、生存和医疗费用的影响。2006 年至 2010 年，纳入了 66632 例新诊断为 LC 的患者（监测组：10527 例，无监测组：56105 例）。与未参与监测计划的患者相比，在诊断前 2 年内参与 NLCSP 一次的患者，LC 早期检测的几率高 1.82 倍（95%置信区间[CI]：1.73 至 1.93）。参与 NLCSP 的患者死亡率降低 22.0%（风险比，0.78；95%CI：0.76 至 0.80）。与未参与监测的患者相比，参与 NLCSP 的患者总医疗费用较高；但在随访期间调整后，其每天的费用较低。本研究强调了参与 NLCSP 的患者的生存获益，并需要在韩国不断改进 NLCSP。
