Do Patients Residing in Provincial Areas Transport and Spend More on Cancer Treatment in Korea?

Abstract

Background: With the increasing burden of cancer worldwide, a need exists to investigate patterns of healthcare utilization and costs. This study aimed to investigate whether the area of residence is associated with the likelihood of a patient receiving treatment at an institution located outside their residing region. This study also analyzed whether medical travel was related to levels of healthcare utilization and costs. Methods: This study used the 2007 to 2015 National Health Insurance (NHI) claims data. The residing area was categorized into capital area, metropolitan cities, and provincial area. Healthcare utilization was measured based on days of care and costs based on direct, covered medical costs. Chi-square test and analysis of variance (ANOVA) was conducted to investigate the general characteristics of the study population. The relationship between the dependent and independent variables were analyzed using the generalized estimating equation (GEE) model. Results: Of the 64,505 participants included in this study, 19,975 (31.0%) visited medical institutions located outside their residing area. Compared to individuals residing in the capital area, those living in provincial regions (OR 2.202, 95% CI 2.068–2.344) were more likely to visit medical institutions outside their residing area. Healthcare costs were higher in individuals receiving treatment at hospitals located elsewhere (RR 1.054, 95% CI 1.017–1.093). Conclusion: Cancer patients residing in provincial areas were likely to visit institutions located outside their residing area for treatment. Medical travel was associated with higher levels of spent healthcare costs. Policies should focus on preventing possible related regional cancer disparity and promoting optimal configuration of cancer services.