Tohoku J. Exp. Med., 2009, 217(3)

The Benefits of Supplementary Private Health Insurance for Healthcare Utilization and Survival among Stomach Cancer Patients

SUNGWOOK KANG,¹ YOUNG DAE KWON,² CHANG HOON YOU,³ JAE HYUNG NOH⁴ and SUNG KIM⁴

¹Department of Public Health, Daegu Haany University, Gyeongsan, Gyeongbuk, Korea
²Department of Medical Humanities and Social Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
³College of Business, Yonsei University, Seoul, Korea
⁴Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Social health insurance (SHI) has covered only 60% of healthcare payments in Korea; therefore, Koreans rely upon supplementary private health insurance (SPHI) to cover the rest of the payments. SPHI status is assumed to affect clinical treatment and outcome of patients with stomach cancer, which is the most prevalent cancer among Koreans. This study examined the relationships between SPHI and diagnosis, treatment, utilization, and survival among stomach cancer patients. Patients (n = 3,780) who underwent a radical gastrectomy from 2000 to 2003 were examined retrospectively. The mean age of all patients was 58 years, and 1,377 patients (36%) had one or more SPHI plan. Univariate analysis was used to examine differences between SPHI and non-SPHI patients in terms of demographic, socioeconomic, and clinical characteristics, followed by a multiple analysis with adjustment for the above parameters. SPHI patients were 5% more likely to visit a physician (p < 0.001) and were 0.8 times less likely to die (p = 0.03) than non-SPHI patients. In contrast, no difference was observed between the two groups in the stage of cancer at diagnosis, which may reflect the fact that the majority of Korean SPHI plans do not cover cancer screening services. Moreover, no significant difference was detected in the use of adjuvant therapy between groups, because it was covered by SHI. In conclusion, SPHI is a determinant of healthcare utilization and survival among stomach cancer patients. It is necessary for health policymakers to consider the benefits of SPHI in financing healthcare services.

keywords —— Diagnosis; Stomach Cancer; Supplementary Private Health Insurance; Survival; Korea.

© 2009 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2009, 217, 243-250

Correspondence: Young Dae Kwon, M.D., Ph.D., Department of Medical Humanities and Social Sciences, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea.

e-mail: snukyd1@naver.com