Health Policy Manag.  2021 Mar;31(1):91-99. 10.4332/KJHPA.2021.31.1.91.

The Impact of Time-to-Treatment for Outcome in Cancer Patients, and Its Differences by Region and Time Trend

• Kim W
• Han KT

• KMID: 2514665
• DOI: http://doi.org/10.4332/KJHPA.2021.31.1.91

Abstract

Background
The Korean government introduced National Cancer Control Program and strengthening national health insurance coverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancer management such as patient concentration or time-to-treatment. Thus, we investigated the association between the time-to-treatment and survival of cancer patients, and compared regional differences by time trend.
Methods
The data used in this study were national health insurance claims data that included patients diagnosed with lung cancer and received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for the association between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences for time-to-treatment by time trend.
Results
A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30 days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30 days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, but it was generally reduced after 2010.
Conclusion
Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improve cancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity and types of cancer.

Keyword

Time-to-treatment; Cancer care; Survival; Patient care management