암환자에서 암발생부위와 생존기간에 따른 사망전 1년간의 의료비용

Medical Expenses by Site of Cancer and Survival Time among Cancer Patients in the Last One Year of Life

  • 이지전 (연세대학교 보건대학원) ;
  • 유원곤 (인제대학교 대학원 보건학과) ;
  • 김소윤 (보건복지부 보건산업진흥과) ;
  • 김광기 (인제대학교 대학원 보건학과) ;
  • 이상욱 (관동대학교 의과대학 예방의학교실)
  • Yi, Jee-Jeon (Graduate School of Public Health, Yonsei University) ;
  • Yoo, Won-Kon (Department of Public Health, The Graduate School, Inje University) ;
  • Kim, So-Yoon (Division of Health Related Industry Promotion, Ministry of Health and Welfare) ;
  • Kim, Kwang-Ki (Department of Public Health, The Graduate School, Inje University) ;
  • Yi, Sang-Wook (Department of Preventive Medicine and Public Health, Kwandong University Medical College)
  • 발행 : 2005.03.01

초록

Objectives : To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. Method : The study subjects were 45,394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. Results : Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived $10{\sim}15$ years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. Conclusions : Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.

키워드

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