Difference in medical service use among Korean gastric cancer survivors according to regional healthcare vulnerabilities: a cohort study

Abstract

Purpose This study investigated the relationship between medical service use and healthcare vulnerability, pre- and post-gastric cancer diagnosis. Differences between healthcare-vulnerable and healthcare-nonvulnerable regions identified inequities that require intervention. Methods This cohort study was done using the National Health Insurance claims data of patients diagnosed with gastric cancer between 2004 and 2013. The Position Value for Relative Comparison Index was used to determine whether the patients lived in a healthcare-vulnerable region. Medical service use was classified into annual outpatient treatment, hospitalization days, and emergency treatment. We used a generalized linear model to which the Poisson distribution was applied and compared regional differences in medical service use. Results A total of 1797 gastric cancer patients who had survived 5 years post-diagnosis were included in the study, of which 14.2% lived in healthcare-vulnerable regions. The patients in vulnerable regions surviving 5–7 years post-diagnosis had a higher number of outpatient visits than those in nonvulnerable regions. Furthermore, hospitalization days were lesser for patients in vulnerable regions who survived 6 years post-diagnosis than those in nonvulnerable regions; however, this number increased in the seventh year. Conclusions Our results suggest that gastric cancer survivors living in healthcare-vulnerable regions have a higher probability of increased medical service use 5 years post-diagnosis compared with patients in nonvulnerable regions, which may significantly increase healthcare disparities over time. Therefore, in the future, additional research is needed to elucidate the causes of the disparities in healthcare use and the results of the differences in health outcomes.

What is the relationship between the local population change and cancer incidence in patients with dyslipidemia: Evidence of the impact of local extinction in Korea

“…24 Furthermore, based on the concept of medical accessibility, some studies have shown a relationship between regional factors, including healthcare accessibility, such as the number of doctors or hospitals, and disease patterns and outcomes. 25,26 Based on our findings, this study examined the relationship between changes in regional characteristics and cancer incidence from a different perspective compared to that in previous studies. Previous studies have often associated local population numbers with cancer incidence, suggesting that they reflect access to healthcare and may contribute to overdiagnosis.…”

“…Studies on regional patterns of cancer incidence in Korea have analyzed the association with preventive aspects of cancer, such as regional factors, eating habits, and coastal accessibility 24 . Furthermore, based on the concept of medical accessibility, some studies have shown a relationship between regional factors, including healthcare accessibility, such as the number of doctors or hospitals, and disease patterns and outcomes 25,26 …”

“… 24 Furthermore, based on the concept of medical accessibility, some studies have shown a relationship between regional factors, including healthcare accessibility, such as the number of doctors or hospitals, and disease patterns and outcomes. 25 , 26 …”