Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2021 Nov 1;36(42):e269. doi: 10.3346/jkms.2021.36.e269.
To determine the priorities and resource allocation of community cancer-related health policies, it is necessary to measure cancer-related health indicators and the burden of cancer by region. This study calculated the cancer-free life expectancy at the level (small administrative units in South Korea) for the first time, and analyzed its association with regional health insurance premiums.
We used aggregate data from the 2008-2017 National Health Information Database provided by the National Health Insurance Service. Cancer-free life expectancy was calculated by applying Sullivan's method to mortality and cancer prevalence by age group and sex for the 10-year period in 3,396 . Correlation analyses were performed to analyze the relationship between cancer-free life expectancy and regional health insurance premiums.
Cancer-free life expectancy in of metropolitan areas tended to be higher than in non-metropolitan areas. However, some of non-metropolitan areas showed quite a high cancer-free life expectancy, especially for females. The median values of differences between cancer-free life expectancy and life expectancy at the level (total: 1.6 years, male: 1.8 years, female: 1.4 years) indicated that a person's healthy life can be shortened by a number of years due to cancer. The association of cancer-free life expectancy by with the regional health insurance premium was statistically significant (β = 1.0, < 0.001) and more prominent for males (β = 1.3, < 0.001) than for females (β = 0.5, < 0.001). The relationship between the regional health insurance premium and the burden of cancer (life expectancy minus cancer-free life expectancy) was also statistically significant (β = 0.2 for the total population, β = 0.2 for males, and β = 0.1 for females, all values < 0.001).
This study showed a significant regional gap with regard to cancer-free life expectancy and the burden of cancer at the level. This work makes a meaningful contribution by presenting new and firsthand summary measures of cancer-related health across small areas in Korea. The results will also help the authorities to evaluate the effectiveness of local cancer management projects in small administrative areas and determine regional priorities for implementing cancer control policies.
为了确定社区癌症相关卫生政策的优先事项和资源分配，有必要按地区衡量癌症相关卫生指标和癌症负担。本研究首次计算了 水平（韩国的小行政区）的无癌预期寿命，并分析了其与地区健康保险费之间的关联。
我们使用了国家健康保险服务提供的 2008-2017 年国家健康信息数据库的汇总数据。通过年龄组和性别应用沙利文方法计算了 10 年内的癌症死亡率和患病率，从而计算了无癌预期寿命。进行相关性分析以分析无癌预期寿命与地区健康保险费之间的关系。
大都市区的无癌预期寿命往往高于非大都市区。但是，一些非大都市区的无癌预期寿命相当高，尤其是女性。无癌预期寿命与 水平的预期寿命之间差异的中位数（总：1.6 年，男性：1.8 年，女性：1.4 年）表明，由于癌症，一个人的健康寿命可能会缩短数年。无癌预期寿命与地区健康保险费之间的关联具有统计学意义（β=1.0，<0.001），对男性（β=1.3，<0.001）的影响比女性（β=0.5，<0.001）更为明显。地区健康保险费与癌症负担（预期寿命减去无癌预期寿命）之间的关系也具有统计学意义（总人口为β=0.2，男性为β=0.2，女性为β=0.1，所有 值均<0.001）。
本研究表明，在 水平上，无癌预期寿命和癌症负担存在显著的地区差距。本研究通过提供韩国小地区癌症相关健康状况的新的和第一手综合衡量标准，做出了有意义的贡献。研究结果还将帮助当局评估小行政区内地方癌症管理项目的有效性，并确定实施癌症控制政策的区域重点。
