J Korean Med Sci.  2021 Nov;36(46):e304. 10.3346/jkms.2021.36.e304.

Underutilisation of Physical Rehabilitation Therapy by Cancer Patients in Korea: a Population-based Study of 958,928 Korean Cancer Patients

• Cho S
• Chung SH
• Kang M
• Jo A
• Sim SH
• Kim YJ
• Yang EJ

• KMID: 2522879
• DOI: http://doi.org/10.3346/jkms.2021.36.e304

Abstract

Background
Advanced cancers are associated with more severe symptoms and greater impairment. Although most patients with metastatic cancer would benefit from rehabilitation, few patients receive appropriate rehabilitation therapy. We explored the use of rehabilitation therapy by cancer patients. Our data represented the entire population of Korea. The analyses were performed according to cancer type and stage.
Methods
We extracted rehabilitation utilization data of patients newly diagnosed with cancer in the period of 2011–2015 from the Korea Central Cancer Registry, which is linked to the claims database of the National Health Insurance Service (n = 958,928).
Results
The utilisation rate increased during the study period, from 6.0% (11,504) of 192,835 newly diagnosed patients in 2011 to 6.8% (12,455) of 183,084 newly diagnosed patients in 2015. Patients with central nervous system (28.4%) and bone (27.8%) cancer were most likely to undergo physical rehabilitation. The rehabilitation rate was higher in patients with metastatic than localised or regional cancer (8.7% vs. 5.3% vs. 5.5%).
Conclusion
This claims-based study revealed that rehabilitation therapy for cancer patients is underutilised in Korea. Although patients with metastasis underwent more intensive rehabilitation than patients with early stage cancer, those without brain and bone tumours (the treatment of which is covered by insurance) were less likely to use rehabilitation services. Further efforts to improve the use of rehabilitation would improve the outcomes of cancer patients.

Keyword

Cancer Rehabilitation; Impairment; Utilisation; Advanced Cancer; National Cancer Registry; National Health Insurance

Figure

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  Fig. 1 Flow chart for the study population of cancer patients diagnosed in Korea, 2011–2015.KCCR = Korea Central Cancer Registry, NHIS = National Health Insurance Service.

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  Fig. 2 Number of claims for rehabilitation therapy by patients newly diagnosed with cancer between 2011 and 2015.

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  Fig. 3 Prevalence of the utilisation of rehabilitation (simple, moderate, or special) by cancer patients according to the SEER stage.SEER = Surveillance, Epidemiology, and End Results.

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  Fig. 4 Prevalence of the utilisation of therapeutic exercise by cancer patients according to the primary cancer type and the SEER stage.CNS = central nervous system, SEER = Surveillance, Epidemiology, and End Results.

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