title: The benefits of supplementary private health insurance for healthcare utilization and survival among stomach cancer patients.
abstract: 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.
authors.affiliation: Department of Public Health, Daegu Haany University, Gyeongsan, Gyeongbuk, Korea.
authors.forename: Sungwook
authors.initials: S
authors.lastname: Kang
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kwon
authors.forename: Chang Hoon
authors.initials: CH
authors.lastname: You
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Noh
authors.forename: Sung
authors.initials: S
authors.lastname: Kim
mesh_terms: D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D007723:Korea / Q000453:epidemiology; D008875:Middle Aged; D017149:Private Sector; D012044:Regression Analysis; D012959:Socioeconomic Factors; D013274:Stomach Neoplasms / Q000191:economics / Q000628:therapy*; D016019:Survival Analysis