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논문KCI 등재

암 환자의 발생 초기 의료비와 이에 영향을 미치는 요인

Costs of Initial Cancer Care and its Affecting Factors

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Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

Abstract

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

참고문헌 (33)

  1. Wilking N, "The burden and cost of cancer", Ann Oncol, 18(3), pp.iii8~iii22 (2007)
  2. Yabroff KR, "Costs of cancer care in the USA: A descriptive review", Nat Clin Pract Oncol, 4(11), pp.643~656 (2007)
  3. Meropol NJ, "Cost of cancer care:Issues and implications", J Clin Oncol, 25(2), pp.180~186 (2007)
  4. Wapner J, "Bills of health: In discussing treatments, cancer doctors plan to include cost", Sci Am, 299(2), pp.28~ (2008)
  5. Report on the Cause of Death Statistics, "Korea National Statistical Office", ~ (2007)
  6. National Cancer Center, "Cancer Facts & Figures 2008" (2008), National Cancer Center
  7. Yabroff KR, "Projections of the costs associated with colorectal cancer care in the US, 2000-2020", Health Econ, 17(8), pp.947~959 (2008)
  8. Warren JL, "Evaluation of trends in the cost of initial cancer treatment", J Natl Cancer Inst, 100(12), pp.888~897 (2008)
  9. Yabroff KR, "Cost of care for elderly cancer patients in the United States", J Natl Cancer Inst, 100(9), pp.630~641 (2008)
  10. Lang K, "Lifetime and treatment-phase costs associated with colorectal cancer:Evidence from SEER-medicare data", Clin Gastroenterol Hepatol, 7(2), pp.198~204 (2009)
  11. Brown ML, "Estimating health care costs related to cancer treatment from SEER-Medicare data", Med Care, 40(8), pp.IV104~IV117 (2002)
  12. 김성경, "우리나라 암 환자의 개인부담 의료비용", 대한내과학회지, 70(1), pp.61~68 (2006), 대한내과학회
  13. 이지전, "암환자에서 암발생부위와 생존기간에 따른 사망전 1년간의 의료비용", 예방의학회지, 38(1), pp.9~15 (2005), 대한예방의학회
  14. 최귀선, "대장암 환자가 부담하는 직접비용: 2년간의 추적조사를 통해", Journal of the Korean Society of Coloproctolgy, 24(5), pp.357~366 (2008), 대한대장항문학회
  15. Reeder CE, "Managing oncology costs", Am J Manag Care, 12(1), pp.S3~S16 (2006)
  16. Yabroff KR, "Patient time costs associated with cancer care", J Natl Cancer Inst, 99(1), pp.14~23 (2007)
  17. Fireman BH, "Cost of care for cancer in a health maintenance organization", Health Care Financ Rev, 18(4), pp.51~76 (1997)
  18. Taplin SH, "Stage, age, comorbidity, and direct costs of colon, prostate, and breast cancer care", J Natl Cancer Inst, 87(6), pp.417~426 (1995)
  19. Warren JL, "Costs of treatment for elderly women with early-stage breast cancer in fee-for service settings", J Clin Oncol, 20(1), pp.307~316 (2002)
  20. Langa KM, "Out of pocket healthcare expenditures among older Americans with cancer", Value Health, 7(2), pp.186~194 (2004)
  21. Oliver E, "Treatment pathways, resource use and costs in the management of small celllung cancer", Thorax, 56(10), pp.785~790 (2001)
  22. Penberthy L, "Predictors of medicare costs in elderly beneficiaries with breast, colorectal, lung, or prostate cancer", Health Care Manag Sci, 2(3), pp.149~160 (1999)
  23. 김성경, "우리나라 성인과 노인의 개인부담 의료비용 지출의 관련요인", 예방의학회지, 38(4), pp.408~414 (2005), 대한예방의학회
  24. Chang S, "Estimating the cost of cancer: Results on the basis of claims data analyses for cancer patients diagnosed with seven types of cancer during 1999 to 2000", J Clin Oncol, 22(17), pp.3524~3530 (2004)
  25. Bosanquet N, "The economics of cancer care in the UK", Lancet Oncol, 5(9), pp.568~574 (2004)
  26. Ries LA, "SEER Cancer Statistics Review, 1975-2005" (2007), National Cancer Institute
  27. Wagner L, "The hidden costs of cancer care: An overview with implications and referral resources for oncology nurses", Clin J Oncol Nurs, 8(3), pp.279~287 (2004)
  28. Ministry for Health, "White Paper on Health, Welfare and Family Affirs" (2007), Ministry for Health, Welfare
  29. Chirikos TN, "Cancer economics: On variations in the costs of treating cancer", Cancer Control, 9(1), pp.59~66 (2002)
  30. Levinsky NG, "Influence fo age on medicare expenditures and medical care in the last of life", JAMA, 286(11), pp.1349~1355 (2001)
  31. Drummond MF, "Methods for the Economic Evaluation of Health Care Programmes" (2005), Oxford University Press
  32. American Cancer Society, "Cancer Facts and Figure 2008" (2008)
  33. Kim SG, "The economic burden of cancer in Korea in 2002", Eur J Cancer Care (Engl), 17(2), pp.136~144 (2008)

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