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Cancer Patients' Utilization of Tertiary Hospitals in Seoul Before and After the Benefit Expansion Policy
Sanghyun Cho1 , Youngs Chang1 , Yoon Kim1,2
1Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
2Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
Corresponding Author: Yoon Kim ,Tel: 02-740-8362, Fax: 02-743-2009, Email: Yoonkim@snu.ac.kr
Received: July 17, 2018;  Accepted: January 4, 2019.
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.
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 (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 1) the five largest hospitals in Seoul and 2) the other tertiary hospitals in Seoul.
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.
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.
Key words: cancer patient; concentration; five biggest hospitals; benefit expansion policy
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