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국내 암환자의 항암제 사용 및 본인부담비용에 대한 실태조사Anticancer Drug Use and Out-Of-Pocket Money Burden in Korean Cancer Patients: A questionnaire Study

Other Titles
Anticancer Drug Use and Out-Of-Pocket Money Burden in Korean Cancer Patients: A questionnaire Study
Authors
김해숙손현순장진경
Issue Date
Sep-2012
Publisher
한국임상약학회
Keywords
cancer; anticancer drug; treatment cost; out-of-pocket money; financial burden; national health insurance coverage
Citation
한국임상약학회지, v.22, no.3, pp 239 - 250
Pages
12
Journal Title
한국임상약학회지
Volume
22
Number
3
Start Page
239
End Page
250
URI
https://scholarworks.sookmyung.ac.kr/handle/2020.sw.sookmyung/52326
ISSN
1226-6051
Abstract
In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for outof-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level,benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.
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