암 진료권별 암 진료 자체충족률의 연도별 추이 및 지역 간 차이 분석: 2008-2023년 건강보험청구자료*

Abstract

= Abstract = Objectives: This study examined temporal trends and regional variation in cancer care self-sufficiency in Korea by treatment stage (diagnosis, first surgery, and first chemotherapy) from 2008 to 2023, comparing the Seoul metropolitan area with non-metropolitan regions. Methods: We analyzed data from the National Health Insurance Claims Database from 2008 to 2023. Incident cancer cases for each calendar year were defined as patients with a new primary cancer diagnosis (ICD-10 codes C00–C97) or a cancer-related eligibility code (V193 or V027), with no record of a cancer diagnosis or cancer-related eligibility code during the preceding two years. Cancer care self-sufficiency was defined as the proportion of cancer-related healthcare utilization occurring within a patient’s region of residence. For each region, annual self-sufficiency rates were calculated by treatment stage and compared between the Seoul metropolitan area and non-metropolitan regions. Results: The self-sufficiency rate in the Seoul metropolitan area remained consistently high, increasing from 97.6% in 2008 to 98.7% in 2023. In contrast, non-metropolitan regions showed substantially lower and declining rates, decreasing from 58.6% to 55.8% over the same period. The self-sufficiency gap between metropolitan and non-metropolitan regions widened at the diagnosis stage, from 24.8 percentage points in 2008 to 32.7 percentage points in 2023, and at the surgery stage, from 48.6 to 49.2 percentage points. In non-metropolitan regions, self-sufficiency was highest at the diagnosis stage and lowest at the surgery and chemotherapy stages. Conclusions: Cancer care self-sufficiency is a key indicator for monitoring regional equity in cancer care and for evaluating policies aimed at reducing the concentration of cancer treatment in the Seoul metropolitan area.