Supporting Low-income Cancer Patients: Recommendations for the Public Financial Aid Program in the Republic of Korea

Min, Hye Sook; Yang, Hyung Kook; Park, Keeho

doi:10.4143/crt.2017.401

Cited by 13 publications

(18 citation statements)

References 16 publications

(19 reference statements)

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“…Cancer is a serious disease not only physically but also socially; morbidity and mortality reduce community productivity 1. Although the cancer survival rate is gradually increasing in Korea, cancer treatment costs are also rising, heavily burdening patients of low socioeconomic status 2. Thus, early detection of resectable cancer is essential to improve survival and reduce costs 1…”

Section: Introductionmentioning

confidence: 99%

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

et al. 2019

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Background The numbers of patients on dialysis and their life expectancies are increasing. Reduced renal function is associated with an increased risk of cancer, but the cancer incidence and sites in dialysis patients compared with those of the general population require further investigation. We investigated the incidences of various cancers in dialysis patients in Korea and used national health insurance data to identify cancers that should be screened in dialysis clinics. Methods We accessed the Korean National Health Insurance Database and excerpted data using the International Classification of Disease codes for dialysis and malignancies. We included all patients who commenced dialysis between 2004 and 2013 and selected the same number of controls via propensity score matching. Results A total of 48,315 dialysis patients and controls were evaluated; of these, 2,504 (5.2%) dialysis patients and 2,201 (4.6%) controls developed cancer. The overall cancer risk was 1.54-fold higher in dialysis patients than in controls (adjusted hazard ratio, 1.71; 95% confidence interval, 1.61–1.81). The cancer incidence rate (incidence rate ratio [IRR], 3.27) was especially high in younger dialysis patients (aged 0–29 years). The most common malignancy of end-stage renal disease patients and controls was colorectal cancer. The major primary cancer sites in dialysis patients were liver and stomach, followed by the lung, kidney, and urinary tract. Kidney cancer exhibited the highest IRR (6.75), followed by upper urinary tract (4.00) and skin cancer (3.38). The rates of prostate cancer (0.54) and oropharyngeal cancer (0.72) were lower than those in the general population. Conclusion Dialysis patients exhibited a higher incidence of malignancy than controls. Dialysis patients should be screened in terms of colorectal, liver, lung, kidney and urinary tract malignancies in dialysis clinics.

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Section: Introductionmentioning

confidence: 99%

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

et al. 2019

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“…However, this does not offset the effect of economic factors on treatment received in Korea, like in other countries [21]. For the lowest income group, additional social care may be needed in addition to the insurance benefit [22].…”

Section: Discussionmentioning

confidence: 99%

Higher Age Puts Lung Cancer Patients at Risk for Not Receiving Anti-cancer Treatment

Choi

Kim

et al. 2019

Cancer Res Treat

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Purpose We aimed to determine the demographic and epidemiologic variables that are associated with no treatment in lung cancer patients. Materials and Methods Patient data were collected from the Korean National Health Insurance Database. The lung cancer group included patients with an initial diagnosis of lung cancer between January 2009 and December 2014. Treated cases were defined as those that underwent surgery, radiation, or chemotherapy until death, after the diagnosis of lung cancer. Risk of no treatment was calculated by multiple logistic regression analysis. Results Among the 2,148 new cases of lung cancer from 2009 to 2104, 612 (28.4%) were not treated. Risk of no treatment was higher in the following patients: patients in their 60s (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.75 to 1.84), 70s (OR, 3.64; 95% CI, 2.41 to 5.50), and >80 years old (OR, 16.55; 95% CI, 10.53 to 25.03) than those in their 50s; patients with previous myocardial infarction (OR, 2.07; 95% CI, 1.01 to 4.25) or chronic kidney disease (OR, 2.88; 95% CI, 1.57 to 5.30); and patients diagnosed at a non-referral hospital (OR, 1.40; 95% CI, 1.01 to 1.92) or primary care provider (OR, 1.81; 95% CI, 1.43 to 2.29) compared with referral hospital. Low-income patients receiving Medicaid were 1.75 times (95% CI, 1.14 to 2.68) more likely to forgo treatment than high-income patients (upper 20%). Risk was not associated with sex or the year in which the lung cancer was diagnosed. Conclusion Age predominantly determines whether patients with lung cancer undergo anti-cancer treatment.

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“…Of the 24 included studies, a significant proportion were conducted in the USA (n = 10) [24][25][26][27][28][29][30][31][32][33]. The remaining studies were from other developed countries, including three from the Republic of Ireland [34][35][36], and Australia [37][38][39], two each from the United Kingdom [40,41] and Republic of Korea [42,43], and one each from Canada [44], Iran [45], Finland [46], and Scotland [47]. Most studies used quantitative survey methods (n = 17 out of 24).…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Financial burden was the most prevalent dimension to emerge, with almost half of all studies (n = 11) focusing on the financial and out-of-pocket costs (OOPCs) associated with cancer treatment. Direct expenses, such as the cost of prescription medication, healthcare specialist fees, travel costs to and from the hospital for treatment, diagnostic or imaging fees, and other hidden costs, such as absenteeism and loss of employment, were problematic [26,27,[31][32][33][34][35]37,43,45,46].…”

Section: Financial Burdenmentioning

confidence: 99%

“…Both copayment applicants (n = 190) and non-applicants (n = 64) were equally likely to sell possessions, work or have family members work longer hours, and use their savings to help to cope with the financial burden of cancer treatment [33]. In a study conducted in the Republic of Korea, Min et al [43] focused on people living with colorectal, stomach, lung, liver, or kidney cancer. Most participants (n = 2366; 87.6%) had experienced financial burden that was more than moderate; 39.2% (n = 1059) had received financial help or a loan, and 17.8% (n = 481) had sold property to afford cancer treatment [43].…”

Section: Financial Burdenmentioning

confidence: 99%

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Burden of Treatment among Elderly Patients with Cancer: A Scoping Review

2021

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Background: The objective of this scoping review is to understand how treatment burden is experienced in elderly patients with cancer and what the most prevalent dimensions of treatment burden are among this population. According to one conceptual model, there are six dimensions of treatment burden, including financial, medication, administrative, time/travel, lifestyle, and healthcare. Methods: A scoping review methodology framework was used to collected data from EMBASE CINAHL (Cumulative Index to Nursing and Allied Health Literature), Medline/PubMed, Scopus, Web of Science, Embase, and Cochrane from 2000 to March 2020. Studies which focused on treatment burden among elderly patients with cancer (+65 years) were selected. Data were extracted using a standardized proforma. Results: The results identified 3319 total papers. Of these, 24 met the inclusion criteria and were included in the scoping review. A significant proportion of these studies was conducted in the United States (n = 10) using self-reported, cross-sectional data. Financial burden was the most prevalent dimension of treatment burden, with 11 studies focusing on the direct and indirect costs associated with cancer treatment. Other but less obvious aspects of treatment burden elderly patients experienced included the length of time taken to access and administer treatment and medication-related burdens. Conclusion: Emerging findings suggest that the financial aspects of cancer treatment are a significant burden for most elderly cancer patients. Personalized healthcare interventions targeting ways to reduce and screen for treatment burden, particularly those related to cost, are urgently needed.

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Supporting Low-income Cancer Patients: Recommendations for the Public Financial Aid Program in the Republic of Korea

Cited by 13 publications

References 16 publications

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study

Higher Age Puts Lung Cancer Patients at Risk for Not Receiving Anti-cancer Treatment

Burden of Treatment among Elderly Patients with Cancer: A Scoping Review

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