Analysis of Prognosis according to Type of Health Insurance in Five Major Gastrointestinal Cancer Patients in Public Hospitals: Single-institution Retrospective Study

Dong Seok Lee; Jaekyung Lee; Ji Won Kim; Kook Lae Lee; Byeong Gwan Kim; Su Hwan Kim; Yong Jin Jung

doi:10.4166/kjg.2020.75.1.17

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Lee, Lee, Kim, Lee, Kim, Kim, and Jung: Analysis of Prognosis according to Type of Health Insurance in Five Major Gastrointestinal Cancer Patients in Public Hospitals: Single-institution Retrospective Study

Original Article

Alimentary Tract

The Korean Journal of Gastroenterology 2020; 75(1): 17-22.

Published online: 29 January 2020

DOI: https://doi.org/10.4166/kjg.2020.75.1.17

Analysis of Prognosis according to Type of Health Insurance in Five Major Gastrointestinal Cancer Patients in Public Hospitals: Single-institution Retrospective Study

Dong Seok Lee, Jaekyung Lee, Ji Won Kim

, Kook Lae Lee, Byeong Gwan Kim, Su Hwan Kim, Yong Jin Jung

Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University of College of Medicine, Seoul, Korea.

Correspondence to: Ji Won Kim, Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University of College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea. Tel: +82-2-870-2221, Fax: +82-2-870-3866, kjwjor@snu.ac.kr

Received 27 May 2019 Revised 13 October 2019 Accepted 2 November 2019

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Public hospitals were established to provide high quality medical services to low socioeconomic status patients. This study examined the effects of public hospitals on the treatment and prognosis of patients with five-major gastrointestinal (GI) cancers (stomach cancer, colon cancer, liver cancer, bile duct cancer, and pancreatic cancer).

Methods

Among the 1,268 patients treated at Seoul National University Boramae Medical Center from January 2010 to December 2017, 164 (13%) were in the medicare group. The data were analyzed to identify and compare the clinical manifestations, treatment modality, and clinical outcomes between the groups.

Results

No statistically significant differences in the clinical data (age, sex), treatment method, and five-year survival rate were observed between the health insurance group and medicare group in the five major GI cancer patients. On the other hand, some medicare group patients tended more comorbidities and fewer treatment options than health insurance patients.

Conclusions

Public hospitals have a positive effect on the treatment and prognosis in medicare group patients with the five-major GI cancers.

Keywords: 5 major gastrointestinal cancer, Hospitals, public, Insurance coverage, Survival

Figures and Tables

Fig. 1

Five-year survival rate of patients between the health insurance group (group H) and medicare group (group M). (A) Stomach cancer. (B) HCC. (C) Colon cancer. (D) Biliary cancer. (E) Pancreatic cancer. F/U, follow up; HCC, hepatocellular carcinoma.

Table 1

Baseline Clinical Characteristics of the Enrolled Patients

Values are presented as mean±standard deviation or n (%).

H, health insurance; M, medicare; Inf, infinity.

^aChi-square test; ^bFisher's exact test.

Table 2

Comparison of the Cancer Stage between the Health Insurance Group and Medicare Groups

Values are presented as n (%).

SEER, Surveillance, Epidemiology, and End Results; H, health insurance; M, medicare.

Table 3

Comparison of the Treatment Modality between the Health Insurance Group and Medicare Groups

Values are presented as n (%).

H, health insurance; M, medicare; CTX, chemotherapy; IMX, immunotherapy; RTX, radiation therapy.

Notes

^{Financial support} This work was supported by a clinical research grant-in-aid from the Seoul Metropolitan Government Seoul National University (SMG-SNU) Boramae Medical Center (03-2017-25).

^{Conflict of interest} None.

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ORCID iDs: Ji Won Kim
https://orcid.org/0000-0002-1214-5544
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