title: Differences in the Survival of Gastric Cancer Patients after Gastrectomy according to the Medical Insurance Status.
abstract: OBJECTIVE
  In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy.
  
  
  METHODS
  A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method.
  
  
  RESULTS
  The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001).
  
  
  CONCLUSIONS
  The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Jae Seong
authors: JS
authors: Jang
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Dong Gue
authors: DG
authors: Shin
authors: Department of Family Medicine, Seoul Medical Center, Seoul, Korea.
authors: Hye Min
authors: HM
authors: Cho
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Yujin
authors: Y
authors: Kwon
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Dong Hui
authors: DH
authors: Cho
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Kyung Bok
authors: KB
authors: Lee
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Sang Soo
authors: SS
authors: Park
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Jin
authors: J
authors: Yoon
authors: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors: Yong Seog
authors: YS
authors: Jang
authors: GI Cancer Center, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea.
authors: Il Myung
authors: IM
authors: Kim
keywords: Health insurance; Stomach neoplasms; Survival