Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan-Si, Republic of Korea.
Cancer Med. 2023 Jul;12(13):14707-14717. doi: 10.1002/cam4.6093. Epub 2023 May 18.
Although strengthening coverage has improved cancer care, there are concerns related to medical distortion. Previous studies have only examined whether patients visit a specific hospital, and not the continuum of patients with cancer, resulting in a lack of evidence in South Korea. This study aimed to investigate the patterns in hospital type for cancer care and analyze their association with outcomes.
The data for this study were obtained from the National Health Insurance Services Sampled Cohort database. This study included patients with four types of cancer (top four cancer incidence in 2020): gastric (3353), colorectal (2915), lung (1351), and thyroid (5158) cancer. The latent class mixed model was used to investigate cancer care patterns, and multiple regression or survival analysis was performed to examine medical cost, length of stay (LOS), and mortality.
The patterns in each cancer type were classified into two to four classes, namely, mainly visited clinics or hospitals, mainly visited general hospitals, mainly visited tertiary hospitals (MT), and tertiary to general hospitals through trajectory modeling based on the utilization of cancer care. Compared to the MT pattern, other patterns were generally associated with higher cost, LOS, and mortality.
The patterns found in this study may be a more realistic way of defining patients with cancer in South Korea compared to previous studies, and its association-related outcomes may be used as a basis to address problems in the healthcare system and prepare alternatives for patients with cancer. Future studies should review cancer care patterns related to other factors such as regional distribution.
尽管加强覆盖范围改善了癌症护理，但仍存在与医疗扭曲相关的担忧。以前的研究仅检查了患者是否访问了特定的医院，而没有检查癌症患者的连续性，因此韩国缺乏证据。本研究旨在调查癌症护理模式，并分析其与结果的关联。
本研究的数据来自国家健康保险服务抽样队列数据库。本研究包括四种类型的癌症患者（2020 年发病率最高的前四种癌症）：胃癌（3353 例）、结直肠癌（2915 例）、肺癌（1351 例）和甲状腺癌（5158 例）。采用潜在类别混合模型研究癌症护理模式，并采用多元回归或生存分析检查医疗费用、住院时间（LOS）和死亡率。
根据癌症护理的利用情况，基于轨迹建模，将每种癌症类型的模式分为两类至四类，即主要就诊于诊所或医院、主要就诊于综合医院、主要就诊于三级医院（MT）和三级至综合医院。与 MT 模式相比，其他模式通常与更高的成本、LOS 和死亡率相关。
与以前的研究相比，本研究中发现的模式可能是一种更现实的韩国癌症患者定义方式，其与结果相关的关联可能被用作解决医疗保健系统问题和为癌症患者准备替代方案的基础。未来的研究应该审查与区域分布等其他因素相关的癌症护理模式。
