Objectives The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013.
Methods This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul).
Results The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect.
Conclusions The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.
Summary
Korean summary
2014년부터 2016년까지 암 발생자 입원의 34.9%가 서울 소재 상급종합병원에서 이루어졌으며, 그중 73.9%가 5대 상급종합병원에서 이루어졌다. 4대 중증질환 보장성 강화 정책 후에 암환자의 서울 소재 상급종합병원 이용은 6.1%(2% 포인트) 증가하였으며, 5대 상급종합병원 이용률은 증가(정책 전: 23.6%, 정책 후: 25.8%), 그 외 서울 소재 상급종합병원 이용률은 감소하였다(정책 전: 9.3%, 정책 후: 9.1%).
Citations
Citations to this article as recorded by
Relationship between patient outcomes and patterns of fragmented cancer care in older adults with gastric cancer: A nationwide cohort study in South Korea Dong-Woo Choi, Seungju Kim, Sun Jung Kim, Dong Wook Kim, Kwang Sun Ryu, Jae Ho Kim, Yoon-Jung Chang, Kyu-Tae Han Journal of Geriatric Oncology.2024; 15(2): 101685. CrossRef
Impact of Disability Status on Mortality in Patients with Gastric Cancer: A Nationwide Study Focusing on Regional Disparities Woo-Ri Lee, Kyu-Tae Han, Mingee Choi, Seojin Park, Woorim Kim Healthcare.2023; 11(5): 641. CrossRef
Descriptive Analysis of Gastric Cancer Mortality in Korea, 2000-2020 Tung Hoang, Hyeongtaek Woo, Sooyoung Cho, Jeeyoo Lee, Sayada Zartasha Kazmi, Aesun Shin Cancer Research and Treatment.2023; 55(2): 603. CrossRef
A 6-year nationwide population-based study on the current status of gastric endoscopic resection in Korea using administrative data Jae Yong Park, Mi-Sook Kim, Beom Jin Kim, Jae Gyu Kim Scientific Reports.2023;[Epub] CrossRef
Cancer care patterns in South Korea: Types of hospital where patients receive care and outcomes using national health insurance claims data Dong‐Woo Choi, Sun Jung Kim, Seungju Kim, Dong Wook Kim, Wonjeong Jeong, Kyu‐Tae Han Cancer Medicine.2023; 12(13): 14707. CrossRef
Changes in the Utilization of Health Care Services by Cancer Patients during the COVID-19 Pandemic Seung Hee Seo, Sooyoung Cho, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin Yonsei Medical Journal.2023; 64(7): 463. CrossRef
Impact of Cardiovascular Diseases on Mortality in Gastric Cancer Patients with Preexisting Chronic Disease Kyu-Tae Han, Dong Wook Kim, Woorim Kim Yonsei Medical Journal.2022; 63(11): 1043. CrossRef
Is time-to-treatment associated with higher mortality in Korean elderly lung cancer patients? Kyu-Tae Han, Woorim Kim, Areum Song, Yeong Jun Ju, Dong-Woo Choi, Seungju Kim Health Policy.2021; 125(8): 1047. CrossRef
Do Patients Residing in Provincial Areas Transport and Spend More on Cancer Treatment in Korea? Woorim Kim, Kyu-Tae Han, Seungju Kim International Journal of Environmental Research and Public Health.2021; 18(17): 9247. CrossRef
This research is based on the Consumption Values theory proposed by Sheth(1991). The purpose of this research is finding the factors related to the process of hospital choice. The expectation of six hospital outpatients 600 was analyzed by six consumption values categories: functional values, social values, emotional value, rarity value, situational values, health related values. The main results of this research is as following; 1. In the result of factor analysis 22 consumption value factors which affect the hospital preference were extracted; kindness/clearness, service speed, comfortabness of space, technical competence in functional values, high income/active social life, low income/blue calar, unmarried/man, middle aged/big family, woman/married, introvert in social values, high-class, comfortableness, reliability in emotional value, newness, classiness in rarity value, social relationship, close to residence, social reputation in situational values, priority on health, health behavior, active sense of value on health in health related values. 2. The difference of consumption values among hospital types were analyzed. The critical factors in reference for corporate hospitals newly established were kindness/ clearness, service speed, convenience, classiness, comfortableness, and newness. University hospitals were preferred by the factors of reliability, and social reputation. In general hospital, convenience and close to residence were critical factor. 3. In logistic regression, age, marital status, education level and income as sociodemographic variables were significaltly related to general hospital choice. Also service speed and close to residence were positively and high income/active social life and high class value were negatively related to general hospital choice. On university hospital choice, age and marital status, education show posive relationship whereas income showing negative relationship. Kindness/clearness, service speed, comfortableness of space, unmarried/man, comfortable feeling, newness and close to residence showed negative relationship with university hospital selection whereas technical competence, reliability in emotional value, classiness in rarity value, social relationship in functional values showed positive relationship. Lastly kindness/clearness, comfortableness of space, high income/active social life, unmarried/man, high-class, comfortableness and newness were positively related to corporate hospitals newly established choice in contast to negative relationship in reliability in emotional value and classiness. In summary, we found that hospital user also choose to hospital in base of various consumption value. Further studis to investigate the hospital consumer behavior will be needed.