Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea.
Int J Public Health. 2023 Jul 6;68:1606000. doi: 10.3389/ijph.2023.1606000. eCollection 2023.
We aimed to investigate the association between fragmented cancer care in the early phase after cancer diagnosis and patient outcomes using national insurance claim data. We identified National Health Insurance beneficiaries diagnosed with lung cancer in South Korea from 2010 to 2014. We included 1,364 lung cancer patients with reduced immortal time bias and heterogeneity. We performed multiple regression analysis using a generalized estimate equation with a gamma distribution for medical expenditures. Among the 1,364 patients with lung cancer, 12.8% had fragmented cancer care. Healthcare costs were higher in fragmented cancer care for both during diagnosis to 365 days and diagnosis to 1,825 days. Linear regression results showed that fragmented cancer care was associated with 1.162 times higher costs during the period from diagnosis to 365 days and 1.163 times the cost for the period from diagnosis to 1,825 days. We found fragmented cancer care is associated with higher medical expenditure. Future health policy should consider the limitation of patients' free will when opting for fragmented cancer care, as there are currently no control mechanisms.
我们旨在使用国家保险索赔数据，调查癌症诊断后早期阶段癌症护理碎片化与患者结局之间的关系。我们从 2010 年至 2014 年确定了韩国被诊断患有肺癌的国家健康保险受益人。我们纳入了 1364 名具有减少的不朽时间偏差和异质性的肺癌患者。我们使用广义估计方程和伽马分布对医疗支出进行了多元回归分析。在 1364 名肺癌患者中，12.8%存在癌症护理碎片化。在诊断后 365 天和诊断后 1825 天期间，癌症护理碎片化的医疗费用更高。线性回归结果表明，诊断后 365 天期间，癌症护理碎片化与费用增加 1.162 倍，诊断后 1825 天期间与费用增加 1.163 倍相关。我们发现癌症护理碎片化与更高的医疗支出有关。未来的卫生政策应考虑到患者在选择癌症护理碎片化时自由意志的局限性，因为目前没有控制机制。
