title: Time trend of out-of-pocket expenditure among cancer inpatients: evidence from Korean tertiary hospitals.
abstract: BACKGROUND
  This study aimed to examine out-of-pocket expenditure for cancer treatments of hospitalized patients and to analyze changing patterns over time.
  
  
  METHODS
  This study examined data of all cancer patients receiving inpatient care from two tertiary hospitals from January 2003 to December 2010. Medical expenditures per admission were calculated and classified into those covered and uncovered by the Korean National Health Insurance (NHI) and co-payment.
  
  
  RESULTS
  The medical expenditure per admission increased slowly from 3,455 thousand Korean won (KRW) to 4,068 thousand KRW. While expenditures covered by the NHI have increased annually, co-payments have generally decreased. The out-of-pocket expenditure ratio, which means the proportion of uncovered expenditure and co-payment among total medical expenditure dropped sharply from 2005 to 2007 and was maintained at a similar level after 2007. Medical expenditures, NHI coverage, and the out-of-pocket expenditure ratio differed across cancer types.
  
  
  CONCLUSIONS
  It is necessary to continually monitor the expenditure of uncovered services by the NHI, and to provide policies to reduce this economic burden. In addition, an individual approach considering cancer type-specific characteristics and medical utilization should be provided.
authors.affiliation: Yonsei Business Research Institute and School of Business, Yonsei University, Korea E-mail : snukyd1@naver.com.
authors.forename: Chang Hoon
authors.initials: CH
authors.lastname: You
authors.forename: Sungwook
authors.initials: S
authors.lastname: Kang
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kwon
authors.forename: Ji Heon
authors.initials: JH
authors.lastname: Choi
mesh_terms: D005382:Financing, Personal / Q000191:economics* / Q000639:trends; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics / Q000639:trends; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data; D009313:National Health Programs / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000191:economics* / Q000628:therapy; D056910:Republic of Korea; D062606:Tertiary Care Centers; D013997:Time Factors