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韩国癌症患者的保险类型与全因死亡率:一项基于全国人口的队列研究

Insurance Types and All-Cause Mortality in Korean Cancer Patients: A Nationwide Population-Based Cohort Study.

作者信息

Shin Jinyoung, Bae Yoon-Jong, Kang Hee-Taik

机构信息

Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea.

Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul 05545, Republic of Korea.

出版信息

J Pers Med. 2024 Aug 14;14(8):861. doi: 10.3390/jpm14080861.

Abstract

BACKGROUND

Economic deprivation is expected to influence cancer mortality due to its impact on screening and treatment options, as well as healthy lifestyle. However, the relationship between insurance type, premiums, and mortality rates remains unclear. This study investigated the relationship between insurance type and mortality in patients with newly diagnosed cancer using data from the Korean National Health Insurance Database.

METHODS

this retrospective cohort study included 111,941 cancer patients diagnosed between 1 January 2007 and 31 December 2008, with a median follow-up period of 13.41 years. The insurance types were categorized as regional and workplace subscribers and income-based insurance premiums were divided into tertiles (T1, T2, and T3).

RESULTS

Cox proportional hazards regression analysis adjusted for age, lifestyle factors, health metrics, and comorbidities showed workplace subscribers ( = 76,944) had a lower all-cause mortality hazard ratio (HR) (95% confidence interval [CI]: 0.940 [0.919-0.961]) compared to regional subscribers ( = 34,997). Higher income tertiles (T2, T3) were associated with lower mortality compared to the T1 group, notably in male regional and workplace subscribers, and female regional subscribers.

CONCLUSION

The study identified that insurance types and premiums significantly influence mortality in cancer patients, highlighting the necessity for individualized insurance policies for cancer patients.

摘要

背景

经济贫困预计会影响癌症死亡率,因为它会对筛查、治疗选择以及健康生活方式产生影响。然而,保险类型、保费与死亡率之间的关系仍不明确。本研究利用韩国国民健康保险数据库的数据,调查了新诊断癌症患者的保险类型与死亡率之间的关系。

方法

这项回顾性队列研究纳入了2007年1月1日至2008年12月31日期间诊断的111,941例癌症患者,中位随访期为13.41年。保险类型分为地区参保者和工作场所参保者,基于收入的保险费分为三分位数(T1、T2和T3)。

结果

在对年龄、生活方式因素、健康指标和合并症进行调整的Cox比例风险回归分析中,与地区参保者(n = 34,997)相比,工作场所参保者(n = 76,944)的全因死亡率风险比(HR)较低(95%置信区间[CI]:0.940[0.919 - 0.961])。与T1组相比,较高收入三分位数(T2、T3)与较低死亡率相关,尤其是在男性地区和工作场所参保者以及女性地区参保者中。

结论

该研究发现保险类型和保费对癌症患者的死亡率有显著影响,凸显了为癌症患者制定个性化保险政策的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/11355516/07f11e07aaa7/jpm-14-00861-g001.jpg

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