건강보험과 의료급여 암 환자의 의료이용 행태와 치료결과 비교

Abstract

Objectives: To investigate the differences in heath care utilization and treatment outcome between National Health Insurance and Medical Aid Program cancer patients. Methods: From National Patient Survey database prepared by Korean Institute for Health and Social Affair 183,796 cancer patients discharge summary data are extracted and analyzed. Two Logistic regression models, one with health insurance status as dependent variable and the other with treatment outcome as dependant variable, were used to determine the differences in outcome and utilization between health insurance types. Results: A Chi-Square test results showed that Medical Aid Program cancer patients used less tertiary care hospitals, more emergency services, and had higher severity level and longer length of stay. However, the logistic regression analysis results showed no significant association between treatment outcome and health insurance status. Conclusions: When the severity related factors such as Charlson Comorbidity Index, length of stay, emergency admission were controled, there were no significant differences in treatment outcome between National Health Insurance and Medical Aid Program cancer patients. However, Medical Aid Program cancer patients were disadvantaged in access to tertiary care hospitals which produced better outcome for cancer patients. Therefore, current policy that requires two stage verifications to access to tertiary care should be reconsidered.