PDF(Pubmed)
Abstract：
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.
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.
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).
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.
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.
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).
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.
摘要：
随着全球癌症负担的增加，有必要调查医疗保健利用和成本的模式。这项研究旨在调查居住区域是否与患者在居住区域以外的机构接受治疗的可能性有关。这项研究还分析了医疗旅行是否与医疗保健利用水平和成本有关。
本研究使用了2007年至2015年的国家健康保险（NHI）索赔数据。居住区被归类为首都地区，大都市,省地区。医疗保健利用率是根据护理天数和基于直接、支付医疗费用。进行卡方检验和方差分析(ANOVA)以调查研究群体的一般特征。使用广义估计方程（GEE）模型分析了因变量和自变量之间的关系。
在本研究纳入的64,505名参与者中，19,975（31.0％）访问了居住地区以外的医疗机构。与居住在首都地区的个人相比，居住在省级地区的人(OR2.202,95%CI2.068-2.344)更有可能去居住地以外的医疗机构就诊.在其他地方的医院接受治疗的个人医疗费用较高(RR1.054，95%CI1.017-1.093)。
居住在省级地区的癌症患者可能会访问居住地区以外的机构进行治疗。医疗旅行与较高的医疗支出相关。政策应侧重于防止可能的相关区域癌症差异，并促进癌症服务的最佳配置。
本研究使用了2007年至2015年的国家健康保险（NHI）索赔数据。居住区被归类为首都地区，大都市,省地区。医疗保健利用率是根据护理天数和基于直接、支付医疗费用。进行卡方检验和方差分析(ANOVA)以调查研究群体的一般特征。使用广义估计方程（GEE）模型分析了因变量和自变量之间的关系。
在本研究纳入的64,505名参与者中，19,975（31.0％）访问了居住地区以外的医疗机构。与居住在首都地区的个人相比，居住在省级地区的人(OR2.202,95%CI2.068-2.344)更有可能去居住地以外的医疗机构就诊.在其他地方的医院接受治疗的个人医疗费用较高(RR1.054，95%CI1.017-1.093)。
居住在省级地区的癌症患者可能会访问居住地区以外的机构进行治疗。医疗旅行与较高的医疗支出相关。政策应侧重于防止可能的相关区域癌症差异，并促进癌症服务的最佳配置。
