OBJECTIVES: The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. METHODS: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). RESULTS: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. CONCLUSIONS: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.
Classification ; Health Policy ; Humans ; Inpatients ; National Health Programs ; Seoul ; Tertiary Care Centers

OBJECTIVES: The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. METHODS: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). RESULTS: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. CONCLUSIONS The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

OBJECTIVES: This study examined trends in inequality in cigarette smoking prevalence by income according to recent anti-smoking policies in Korea. METHODS: The data used in this study were drawn from three nationally representative surveys, the Korea National Health and Nutrition Examination Survey, the Korea Community Health Survey, and the Social Survey of Statistics Korea. We calculated the age-standardized smoking prevalence, the slope index of inequality, and the relative index of inequality by income level as a socioeconomic position indicator. RESULTS: Smoking prevalence among men decreased during the study period, but the downward trend became especially pronounced in 2015, when the tobacco price was substantially increased. Inequalities in cigarette smoking by income were evident in both genders over the study period in all three national surveys examined. Absolute inequality tended to decrease between 2014 and 2015 among men. Absolute and relative inequality by income decreased between 2008 and 2016 in women aged 30-59, except between 2014 and 2015. CONCLUSIONS: The recent anti-smoking policies in Korea resulted in a downward trend in smoking prevalence among men, but not in relative inequality, throughout the study period. Absolute inequality decreased over the study period among men aged 30-59. A more aggressive tax policy is warranted to further reduce socioeconomic inequalities in smoking in young adults in Korea.
Female ; Health Surveys ; Humans ; Korea* ; Male ; Nutrition Surveys ; Prevalence* ; Smoke ; Smoking* ; Socioeconomic Factors* ; Taxes ; Tobacco ; Tobacco Products* ; Young Adult

Purpose: The purpose of this study is to determine the level of health equity in relation to cancer incidence. Materials and Methods: We used the National Health Insurance claims data of the National Health Insurance Service between 2005 and 2022 and annual health insurance and medical aid beneficiaries between 2011 and 2021 to investigate the disparities of cancer incidence. We calculated age-sex standardized cancer incidence rates by cancer and year according to the type of insurance and the trend over time using the annual percentage change. We also compared the hospital type of the first diagnosis by cancer type and year and cancer incidence rates by cancer type and region in 2021 according to the type of insurance. Results: The total cancer incidence increased from 255,971 in 2011 to 325,772 cases in 2021. The absolute difference of total cancer incidence rate between the NHI beneficiaries and the medical aid (MA) recipients increased from 510.1 cases per 100,000 population to 536.9 cases per 100,000 population. The odds ratio of total cancer incidence for the MA recipients increased from 1.79 (95% confidence interval [CI], 1.77 to 1.82) to 1.90 (95% CI, 1.88 to 1.93). Disparities in access to hospitals and regional cancer incidence were profound. Conclusion This study examined health inequities in relation to cancer incidence over the last decade. Cancer incidence was higher in the MA recipients, and the gap was widening. We also found that regional differences in cancer incidence still exist and are getting worse. Investigating these disparities between the NHI beneficiaries and the MA recipients is crucial for implementing of public health policies to reduce health inequities.

BACKGROUND: This study addressed town-level mortality rates using the National Health Information Database (NHID) of the National Health Insurance Service in Korea in comparison with those derived from the National Administrative Data (NAD) of the Ministry of Interior and Safety. METHODS: We employed the NHID and NAD between 2014 and 2017. We compared the numbers of population and deaths at the national level between these two data sets. We also compared the distribution of the town-level numbers of population and deaths of the two data sets. Correlation analyses were performed to investigate the relation between the NHID and NAD in the town-level numbers of population and deaths, crude mortality rate, and standardized mortality ratio (SMR). RESULTS: The numbers of population and deaths in the NHID were almost identical to those in the NAD, regardless of gender. The distribution of the town-level numbers of population and deaths was also similar between the two data sets during the entire study period. Throughout the study period, the Pearson correlation coefficients between the two databases for the town-level numbers of population and deaths and the crude mortality rate were 0.996 or over. The correlation coefficients for the SMR ranged from 0.937 to 0.972. CONCLUSION: Town-level mortality showed significant correlation and concordance between the NHID and NAD. This result highlights the possibility of producing future analyses of town-level health-related indicators in Korea, including the mortality rate, using the NHID.
Dataset ; Korea ; Mortality ; NAD ; National Health Programs ; Republic of Korea ; Statistics as Topic