J Gastric Cancer.  2013 Dec;13(4):247-254.

Differences in the Survival of Gastric Cancer Patients after Gastrectomy according to the Medical Insurance Status

• Jang JS
• Shin DG
• Cho HM
• Kwon Y
• Cho DH
• Lee KB
• Park SS
• Yoon J
• Jang YS
• Kim IM

Abstract

PURPOSE
In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy.
MATERIALS AND METHODS
A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method.
RESULTS
The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001).
CONCLUSIONS
The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.

Keyword

Stomach neoplasms; Health insurance; Survival

MeSH Terms

Gastrectomy*
Hospitalization
Humans
Insurance Coverage*
Insurance*
Insurance, Health
Korea
Methods
Mortality
National Health Programs
Seoul
Social Class
Stomach Neoplasms*
Survival Rate

Figure

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  Fig. 1 Overall survival curves according to the national health insurance status. NHIG = national health insurance registered group; MAG = medical aid covered group.

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  Fig. 2 Survival curves according to the health insurance status in each TNM (7th) stage. NHIG = national health insurance registered group; MAG = medical aid covered group.

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