Changes in Korean National Healthcare Insurance Policy and Breast Cancer Surgery Trend in Korea
10.3346/jkms.2021.36.e194
- Author:
Musaed RAYZAH
1
;
Jai Min RYU
;
Jun-Hee LEE
;
Seok Jin NAM
;
Seok Won KIM
;
Se Kyung LEE
;
Jonghan YU
;
Kyeong-Tae LEE
;
Sa-Ik BANG
;
Goo-Hyun MUN
;
Jai-Kyong PYON
;
Byung-Joon JEON
;
Jeong Eon LEE
Author Information
1. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2021;36(29):e194-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Since April 2015, the Korean National Health Insurance (NHI) has reimbursed breast cancer patients, approximately 50% of the cost of the breast reconstruction (BR) procedure. We aimed to investigate NHI reimbursement policy influence on the rate of immediate BR (IBR) following total mastectomy (TM).
Methods:We retrospectively analyzed breast cancer data between April 2011 and June 2016. We divided patients who underwent IBR following TM for primary breast cancer into “uninsured” and “insured” groups using their NHI statuses at the time of surgery. Univariate analyses determined the insurance influence on the decision to undergo IBR.
Results:Of 2,897 breast cancer patients, fewer uninsured patients (n = 625) underwent IBR compared with those insured (n = 325) (30.0% vs. 39.8%, P < 0.001). Uninsured patients were younger than those insured (median age [range], 43 [38–48] vs. 45 [40–50] years; P < 0.001).Pathologic breast cancer stage did not differ between the groups (P = 0.383). More insured patients underwent neoadjuvant chemotherapy (P = 0.011), adjuvant radiotherapy (P < 0.001), and IBR with tissue expander insertion (P = 0.005) compared with those uninsured.
Conclusion:IBR rate in patients undergoing TM increased after NHI reimbursement.
