scholarly journals The Financial Burden Associated with Medical Costs among Childhood Cancer Patients and Their Families Related to Their Socioeconomic Status: The Perspective of National Health Insurance Service

2020 ◽  
Vol 17 (17) ◽  
pp. 6020
Author(s):  
Wonjeong Chae ◽  
Juyeong Kim ◽  
Sohee Park ◽  
Eun-Cheol Park ◽  
Sung-In Jang
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Medical Cost ◽  
Financial Burden ◽  
Treatment Phase ◽  
Medical Costs ◽  
Initial Diagnosis ◽  
Total Medical Cost

The number of cancer survivors is increasing as a consequence of improved therapeutic options. Many families are suffering from the resultant financial burden. Our study aims to determine the total medical cost for 5 years after the initial diagnosis of childhood cancers. A customized dataset from the Korean National Health Insurance Claims Database was requested for this study. A total of 7317 patients were selected to determine the total medical cost. The costs are presented as the 2% trimmed mean value to exclude extreme costs. The medical costs were further classified according to cancer type, treatment phase, and socioeconomic status. Multiple linear regression analyses were performed. The average total medical cost per patient is 36.8 million Korean Wons or 32,157 United States Dollars. Analysis of socioeconomic status revealed that the higher income group demonstrated higher medical expenditure when compared to other groups. Analysis of the treatment phase showed that costs associated with the early phase of treatment are the highest, especially in the first 3 months after initial diagnosis. To alleviate the financial burden and reduce the socioeconomic disparities associated with medical care and costs, a better understanding of the current experience of patients and their families is required.

scholarly journals Relationship of Socioeconomic Status to Arterial Stiffness: Comparison Between Medical Aid Beneficiaries and National Health Insurance Beneficiaries

2020 ◽  
Vol 33 (8) ◽  
pp. 718-725
Author(s):  
Hack-Lyoung Kim ◽  
Jin Yong Lee ◽  
Woo-Hyun Lim ◽  
Jae-Bin Seo ◽  
Sang-Hyun Kim ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Arterial Stiffness ◽  
National Health Insurance ◽  
National Health ◽  
Low Socioeconomic Status ◽  
Multivariable Analysis ◽  
Laboratory Findings ◽  
Low Socioeconomic ◽  
Medical Aid

Abstract Background There is no general agreement on underlying pathophysiology explaining the high burden of cardiovascular disease on people at low socioeconomic status (SES). This study was conducted to investigate the association between healthcare systems and arterial stiffness. Methods A total of 8,929 subjects (60 years old and 55% were male) who underwent brachial-ankle pulse wave velocity (baPWV) measurement were retrospectively analyzed. There were 8,237 National Health Insurance (NHI) beneficiaries (92.2%) and 692 medical aid (MA) beneficiaries (7.8%). The median value of baPWV was 1,540 cm/s. Results Subjects with higher baPWV values (≥1,540 cm/s) were older, and more frequently had cardiovascular risk factors and unfavorable laboratory findings than those with lower values baPWV (<1,540 cm/s). The baPWV values were significantly higher in MA beneficiaries than in NHI beneficiaries (1,966 ± 495 vs. 1,582 ± 346 cm/s, P < 0.001). The proportion of MA beneficiaries was significantly higher in subjects with higher baPWV than those with lower baPWV (13.1% vs. 2.3%, P < 0.001). In multivariable analysis, MA beneficiaries were significantly associated with higher baPWV values even after controlling for potential confounders (odds ratio, 5.41; 95% confidence intervals, 4.02–7.27; P < 0.001). Conclusions The baPWV values were significantly higher in MA beneficiaries than in NHI beneficiaries. The result of this study provides additional evidence on the association between low SES and arterial stiffening.

scholarly journals Medical costs of obese Japanese: a 10-year follow-up study of National Health Insurance in Shiga, Japan

2007 ◽  
Vol 17 (5) ◽  
pp. 424-429 ◽  
Author(s):  
K. Nakamura ◽  
T. Okamura ◽  
H. Kanda ◽  
T. Hayakawa ◽  
A. Okayama ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Medical Costs ◽  
Follow Up Study

scholarly journals Financial Burden and Health-seeking Behaviors Related to Chronic Diseases Under the National Health Insurance Scheme in Bolikhamxay Province, Lao PDR: A Cross-sectional Study

2021 ◽  
Author(s):  
TOMOO ITO ◽  
Sengchanh Kounnavong ◽  
Chiaki Miyoshi
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Expenditure ◽  
Financial Burden ◽  
Lao Pdr ◽  
Health Seeking ◽  
Chronic Patients ◽  
National Health Insurance System ◽  
Cross Sectional

Abstract BackgroundFinancial protection is a key dimension of universal health coverage. In 2016, Lao PDR implemented a National Health Insurance system covering the entire population of certain provinces. This cross-sectional study investigated the health-seeking behavior and financial burden of households, including those with chronic patients, post coverage. MethodThe study was conducted in Bolikhamxay province from January 15 to February 13, 2019. In total, 487 households, selected via stratified random sampling, were surveyed, and questionnaire-based interviews were conducted. Health care service utilization and financial burden were examined.ResultsA total of 370 households had at least one member with some type of self-reported health problem within the last 3 months prior to the interview, while 170 had at least one member with a chronic condition. More than 75% of the households accessed a health facility when a member experienced health problems. The prevalence of catastrophic health expenditure (health expenditure/income between 20% and 40%) was 25.1% (threshold of 20%) and 16.2% (threshold of 40%). Through logistic regression, we found that the major factors determining financial catastrophes owing to health problems were household members with chronic illness, hospitalization, household poverty status, family size (both 20% and 40% thresholds), visiting a private facility (20% threshold), and distance from the province to the referral hospital (40% threshold).ConclusionsThe National Health Insurance system has positively impacted households’ access to health facilities. However, catastrophic health expenditure remains high, especially among chronic patients. Facilities under the National Health Insurance should be strengthened to provide more services, including care for chronic conditions.

scholarly journals Financial Burden and Health-seeking Behaviors Related to Chronic Diseases Under the National Health Insurance Scheme in Bolikhamxay Province, Lao PDR: a Cross-sectional Study

2021 ◽  
Author(s):  
Tomoo Ito ◽  
Chiaki Miyoshi ◽  
Sengchanh Kounnavong
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Expenditure ◽  
Financial Burden ◽  
Lao Pdr ◽  
Health Seeking ◽  
Chronic Patients ◽  
National Health Insurance System ◽  
Cross Sectional

Abstract Background: Financial protection is a key dimension of universal health coverage. In 2016, Lao PDR implemented the National Health Insurance system covering the entire population of certain provinces. This cross-sectional study investigated households’ health-seeking behavior and their financial burden with chronic patients, post coverage. Method: The study was conducted in Bolikhamxay province from January 15 to February 13, 2019. In total, 487 households, selected via stratified random sampling, were surveyed, and questionnaire-based interviews conducted. Health care service utilization and financial burden were examined.Results: Totally, 370 households had at least one member with some type of self-reported health problem within the last 3 months prior to the interview, while 170 had at least one member with a chronic condition. More than 75% of the households accessed a health facility when a member experienced health problems. We observed that the prevalence of catastrophic health expenditure (health expenditure/income between 20% and 40%) was 25.1% (threshold of 20%) and 16.2% (threshold of 40%). Through logistic regression, we found that the major factors determining financial catastrophes owing to health problems were household members with chronic illness, hospitalization, household poverty status, family size (both 20% and 40% thresholds), visiting a private facility (20% threshold), and distance from provincial top referral hospital (40% threshold).Conclusions: The National Health Insurance system has positively impacted households’ access to health facilities. However, catastrophic health expenditure remains high, especially among chronic patients. Facilities under National Health Insurance should be strengthened to provide more services, including care for chronic conditions.

scholarly journals National practice patterns and direct medical costs for prostate cancer in Korea across a 10 year period: a nationwide population-based study using a national health insurance database

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ho Won Kang ◽  
Seok-Joong Yun ◽  
Jae Il Chung ◽  
Hoon Choi ◽  
Jae Heon Kim ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Practice Patterns ◽  
Combined Therapy ◽  
Medical Costs ◽  
Treatment Costs ◽  
Direct Medical Costs ◽  
National Practice

Abstract Background A complete enumeration study was conducted to evaluate trends in national practice patterns and direct medical costs for prostate cancer (PCa) in Korea over a 10-year retrospective period using data from the Korean National Health Insurance Service. Methods Reimbursement records for 874,924 patients diagnosed between 2002 and 2014 with primary PCa according to the International Classification of Disease (ICD) 10th revision code C61 were accessed. To assess direct medical costs for patients newly diagnosed after 2005, data from 68,596 patients managed between January 2005 and 31 December 2014 were evaluated. Results From 2005 to 2014, the total number of PCa patients showed a 2.6-fold increase. Surgery and androgen deprivation therapy were the most common first-line treatment, alone or within the context of combined therapy. Surgery as a monotherapy was performed in 23.5% of patients in 2005, and in 39.4% of patients in 2014. From 2008, the rate of robot-assisted RP rose sharply, showing a similar rate to open RP in 2014. Average total treatment costs in the 12 months post-diagnosis were around 10 million Korean won. Average annual treatment costs thereafter were around 5 million Korean won. Out-of-pocket expenditure was highest in the first year post-diagnosis, and ranged from 12 to 17% thereafter. Conclusions Between 2005 and 2014, a substantial change was observed in the national practice pattern for PCa in Korea. The present data provide a reliable overview of treatment patterns and medical costs for PCa in Korea.

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