Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea.
BMC Health Serv Res. 2024 Sep 16;24(1):1076. doi: 10.1186/s12913-024-11494-y.
Gastric cancer is the fourth most common cancer and highly prevalent in South Korea. As one of the predictors of gastric cancer, we focused on health utilization patterns and expenditures, as the surrogate variables of health conditions. This nested case-control study aimed to identify the association between health expenditure trajectory and incidence of gastric cancer.
Data from the National Health Insurance Service Senior Cohort of South Korea were used. Individuals diagnosed with gastric cancer (N = 14,873) were matched to a non-diagnosed group (N = 44,619) in a 1:3 ratio using a nested case-control design. A latent class trajectory analysis was performed to identify the patterns of health expenditure among the matched participants. Furthermore, conditional logistic regression analysis was conducted to examine the relationship between healthcare expenditure trajectories and gastric cancer incidence.
Seven distinct health expenditure trajectories for five years were identified; consistently lowest (13.8%), rapidly increasing (5.9%), gradually increasing (13.8%), consistently second-highest (21.4%), middle-low (18.8%), gradually decreasing (13.1%), and consistently highest (13.2%). Compared to the middle-low group, individuals in the rapidly increasing [odds ratio (OR) = 2.11, 95% confidence interval (CI); 1.94-2.30], consistently lowest (OR = 1.40, 95% CI; 1.30-1.51), and gradually increasing (OR = 1.26, 95% CI; 1.17-1.35) groups exhibited a higher risk of developing gastric cancer.
Our findings suggest that health expenditure trajectories are predictors of gastric cancer. Potential risk groups can be identified by monitoring health expenditures.
胃癌是全球第四大常见癌症，在韩国的发病率较高。作为胃癌的预测因素之一，我们关注健康利用模式和支出，将其作为健康状况的替代变量。本巢式病例对照研究旨在确定健康支出轨迹与胃癌发病之间的关联。
本研究使用了韩国国家健康保险服务老年人队列的数据。通过巢式病例对照设计，将被诊断为胃癌的个体（N=14873）与未被诊断为胃癌的个体（N=44619）按 1:3 的比例进行匹配。对匹配参与者进行潜在类别轨迹分析，以确定健康支出模式。此外，采用条件逻辑回归分析来检验医疗保健支出轨迹与胃癌发病之间的关系。
确定了五年内七种不同的健康支出轨迹：持续最低（13.8%）、快速增加（5.9%）、逐渐增加（13.8%）、持续第二高（21.4%）、中低（18.8%）、逐渐减少（13.1%）和持续最高（13.2%）。与中低组相比，快速增加组（比值比[OR] = 2.11，95%置信区间[CI]；1.94-2.30）、持续最低组（OR = 1.40，95% CI；1.30-1.51）和逐渐增加组（OR = 1.26，95% CI；1.17-1.35）患胃癌的风险更高。
我们的研究结果表明，健康支出轨迹是胃癌的预测因素。通过监测健康支出，可以识别出潜在的高风险人群。
