Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
권호 표지
DOI QR코드

DOI QR Code

Cancer patients' need for financial assistance and its related factors

암 환자가 느끼는 경제적 도움에 대한 필요와 이에 영향을 미치는 요인

  • Kim, Youn-Gu (Ajou University, School of Public Health) ;
  • Park, Jae-Hyun (Department of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University College of Medicine) ;
  • Park, Jong-Hyock (National Cancer Control Research Institute, National Cancer Center)
  • 김윤구 (아주대학교 보건대학원) ;
  • 박재현 (성균관대학교 의과대학 사회의학교실) ;
  • 박종혁 (국립암센터 국가암관리사업단)
  • Received : 2010.08.11
  • Accepted : 2010.12.05
  • Published : 2010.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background : Cancer is a disease that not only places a significant burden on patients clinically but also requires significant expense for diagnosis and treatment. Although the cancer coverage of health insurance has recently been expended, the need for financial assistance among cancer patients and their families is still expected to be significant. In this study, cancer patients' need for financial assistance in Korea was examined and its influence factors were analyzed. Methods : Target study subjects were those who are over 18 years of age and were diagnosed with cancer more than four months prior at the National Cancer Center and 9 Regional Cancer Centers in Korea during the period from July to August of 2008. Quarter sampling was conducted according to the ratio of the type of each cancer. A face to face interview survey was conducted. A total of 2,661 cancer patients finished the survey. Medical charts were reviewed in order to obtain the cancer type and SEER stage of cancer patients. An ordered logistic regression model was used to examine the level of need for financial assistance according to the demographical, clinical, and socio-economic variables of cancer patients. Result : The percentage of cancer patients who needed financial assistance was 69.0%, and 36.9% needed significant financial assistance. The need for financial assistance was perceived to be greater in males, younger age group, low income group, low education group, medical aid recipients, those who were diagnosed recently, those with a low level of quality of life measured through EQ5D, and those with decreased income after cancer diagnosis. Conclusion : In spite of the current policy to increase health insurance coverage, the majority of cancer patients and their families in Korea still need financial assistance due to cancer. In particular, there were more vulnerable groups, such as the low income, or low education group. In the future, policies that focus on the disadvantaged, which strengthen social security, should be considered for achievement of a substantially better quality of life for cancer patients and their families.

Keywords

References

  1. 국가암정보센터. 서울. 보건복지부. [cited 2010 Jun 10]. Available from : URL : http://www .cancer.go.kr/cms/statics/incidence/index.html. 2010
  2. 김성경, 박웅섭. 우리나라 암 환자의 개인부담 의료비용 우리나라 암 환자의 개인 부담 의료비용. 대한내과학회지 2006;70(1):61-68.
  3. 김진희, 함명일, 박은철, 박재현, 박종혁, 김성은 등. 2005년 암의 경제적 비용부담 추계. 예방의학회지 2009;49(3):190-198. https://doi.org/10.3961/jpmph.2009.42.3.190
  4. 박은철, 최귀선, 곽민선, 김성경, 김 희, 김윤미 등. 암 검진의 효과 평가 및 암 비용 연구. 국립암센터 2006;106-175.
  5. 보건복지부. (개정 2009. 11. 25, 본인일부부담금 산정특례에 관한 기준 제2009-208호)
  6. 보건복지부. 소득계층에 따른 암 환자의 암 종별 의료이용에 관한 연구(Inequality on Medical Service Utilization among Cancer Patients across Income Groups). 서울: 보건복지부: 2008
  7. 보건복지가족부. 암정복 2015. 서울; 보건복지부: 2006
  8. 윤영호, 이영선, 남소영, 박상민, 이정석, 박명희 등. 말기암이 환자가족에게 미치는 사회경제적 영향 및 관련 요인. 가정의학회지 2005;26:31-39.
  9. 이의경. 약물치료학 제8장 의약품 경제성평가. 서울: 신일상사; 2006
  10. 지은정. 의료비 지출이 종사상 지위 및 소득변화에 미치는 요인연구. 한국사회복지학 2004;56(3):5-35.
  11. 홍백의, 손은정. 암환자 가족의 경제적 손실비용과 그 영향 요인 암환자 가족의 경제적 손실비용과 그 영향 요인. 사회복지연구 2008 ; 38 :193-215.
  12. Bloom BS, Knorr RS, Evans AE. The Epidemiology of Disease Expenses : The Costs of Caring for Children With Cancer. JAMA 1985 ; 253:2393-2397. https://doi.org/10.1001/jama.253.16.2393
  13. Covinsky KE, Goldman L, Cook EF, Oye R, Desbiens N, Reding D, et al. The impact of serious illness on patients' families. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. JAMA 1994;272: 1839-44. https://doi.org/10.1001/jama.272.23.1839
  14. Doorslaer EV, Wagstaff A, Bleichrodt H, Calonge S, Gerdtham U-G, Gerfin M et al. Income-related inequalities in health : some international comparisons. J Health Econ 1997;16:93-112. https://doi.org/10.1016/S0167-6296(96)00532-2
  15. Gross DJ, Alecxih L, Gibson J, Caplan C, Brangan N. Out-of-poket Health Spending by Poor and Near-Poor elderly Medicare beneficiaries. Health Serv Res 1999;34:241-254
  16. Houts P, Yasko J, Harvey HA. Unmet needs of persons with cancer in Pennsylvania durring the period of terminal care. Cancer 1988 ; 62:627-634 https://doi.org/10.1002/1097-0142(19880801)62:3<627::AID-CNCR2820620331>3.0.CO;2-1
  17. Jansen C, Halliburton P, Dibble S, Dodd MJ. Family problems during cancer chemotherapy. Oncol Nurs Forum 1993;20:689-696
  18. Korea National Statistical Office. Korea Statistical Information Service. Deajeon : Korea National Statistical Office ; [cited 2010 May 17]. Available from: URL : http://kosis.kr/nsportal/themes/themes_03List.jsp
  19. Korea National Statistical Office. Korea Statistical Information Service. Deajeon : Korea National Statistical Office ; [cited 2010 Sep 10]. Available from : URL : http://www.kosis.kr/common/meta_onedepth.jsp? vwcd=MT_CTITLE&listid=MT_CTITLE_9
  20. Langa KM, Fendrick AM, Chernew ME, Kabeto MU, Paisley KL, Hayman JA. Out of pocket healthcare expenditures among older Americans with cancer. Value Health 2004;20(1):186-194.
  21. Lansky SB, Cairns NU, Clark GM, Lowman, J, Miller L, Trueworthy R. Childhood cancer : Nonmedical costs of the illness. Cancer 1979; 43:403-408. https://doi.org/10.1002/1097-0142(197901)43:1<403::AID-CNCR2820430157>3.0.CO;2-L
  22. Longo CJ, Fitch M, Deber RB, Williams AP. Financial and family burden associated with cancer treatment in Ontario, Canada. Support Care Cancer 2006;14:1077-1085. https://doi.org/10.1007/s00520-006-0088-8
  23. Moore K. Breast cancer patients' out-of-poket expenses. Cancer Nurs 1999;22:389-396 https://doi.org/10.1097/00002820-199910000-00007
  24. OECD. Health Data 2006. Paris ; OECD: 2006
  25. Park JH, Park JH, Kim SG. Effect of cancer diagnosis on patient employment status : a nationwide longitudinal study in Korea. Psychooncology 2009;18(7):691-9. https://doi.org/10.1002/pon.1452
  26. Park JH, Park EC, Park JH, Kim SG, Lee SY. Job loss and re-employment of cancer patients in Korean employees : a nationwide retrospective cohort study. J Clin Oncol 2008;26(8):1302-1309. https://doi.org/10.1200/JCO.2007.14.2984
  27. Park JH, Park JH, Kim SG, Lee KS, Hahm MI. Changes in employment status and experience of discrimination among cancer patients : findings from a nationwide survey in Korea. Psychooncology. 2010 ;[Epub ahead of print]
  28. Siegel K, Raveis VH, Houts P, Mor V. Caregiver burden and unmet patient needs. Cancer 1991;68:1131–1140.
  29. Wanger L, Lacey MD. The hidden costs of cancer care : An overview with implications and referral resources for oncology nurses. Clin J Oncol Nurs 2004;8(3):279-287. https://doi.org/10.1188/04.CJON.279-287
  30. Wapner J. Bills of health: In discussing treatments, cancer doctors plan to include cost. Sci Am 2008;299(2):28. https://doi.org/10.1038/scientificamerican0808-28
  31. Wilking N, Jonsson B. The burden and cost of cancer. Ann Oncol 2007;18(Suppl 3) :iii8-iii22. https://doi.org/10.1093/annonc/mdm097
  32. World Health Organization. Health topics. Geneva. World Health Organization; [cited 2010 May 17]. Available from: URL : http://www.who.int/mediacentre/factsheets/ fs297/en/
  33. Yun YH, Rhee YS, Kang IO, Lee JS, Bang SM, Lee WS, et al. Economic burdens and quality of life of family caregivers of cancer patients. Oncology 2005;68(2-3):107-14. https://doi.org/10.1159/000085703

Cited by

  1. Quality of life of older adults with cancer in Korea vol.57, pp.7, 2018, https://doi.org/10.1080/00981389.2018.1467355