Relationship between socioeconomic status and accessibility for endoscopic resection among gastric cancer patients

using National Health Insurance Cohort in Korea: poverty and endoscopic resection

Na Yeon Kim, Jun Seok Oh, Young Choi, Jaeyong Shin, Euncheol Park

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Gastric cancer is one of the most common types of cancer among patients in Korea. We measured the inequity in accessibility to endoscopic mucosal/submucosal resection (EMR) for early and curable gastric cancer treatment among different income classes in patients diagnosed from late 2011 to 2013. Methods: Data were obtained from the National Health Insurance Cooperation Claim Data from patients diagnosed from late 2011 until the end of 2013, to provide a total of 1,671 patients with newly diagnosed carcinoma in situ of gastric and gastric cancer among 1,025,340 enrollees. Multiple logistic regression analysis was conducted to investigate the associations between independent variables and the rate of treatment with EMR. Results: Among 1671 gastric cancer patients, 317 (19.0 %) subjects were treated with EMR. The ‘lowest’ income group was associated with a statistically significant lower rate of EMR treatment [odds ratio (OR) = 0.55, 95 % confidence index (CI) 0.34–0.89] compared to the ‘highest’ income group. The ORs for the ‘low-middle’ and ‘middle-high’ income groups were both higher than for the reference group, although these were not significantly different. According to the subgroup analysis by gender, rate of EMR treatment of ‘lowest’ income group (OR = 0.37, 95 % CI 0.18–0.74) was significantly lower only among men. Conclusion: In conclusion, we suggest that although universal health insurance in Korea has covered EMR treatment since August 2011, patients from the lowest income group are less likely to receive this treatment. Thus, we need to detect more eligible early-stage gastric cancer and treatment for individuals of low socioeconomic status.

Original languageEnglish
Pages (from-to)61-69
Number of pages9
JournalGastric Cancer
Volume20
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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National Health Programs
Poverty
Korea
Social Class
Stomach Neoplasms
Therapeutics
Odds Ratio
Carcinoma in Situ
Health Insurance
Endoscopic Mucosal Resection
Stomach
Logistic Models
Regression Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

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title = "Relationship between socioeconomic status and accessibility for endoscopic resection among gastric cancer patients: using National Health Insurance Cohort in Korea: poverty and endoscopic resection",
abstract = "Background: Gastric cancer is one of the most common types of cancer among patients in Korea. We measured the inequity in accessibility to endoscopic mucosal/submucosal resection (EMR) for early and curable gastric cancer treatment among different income classes in patients diagnosed from late 2011 to 2013. Methods: Data were obtained from the National Health Insurance Cooperation Claim Data from patients diagnosed from late 2011 until the end of 2013, to provide a total of 1,671 patients with newly diagnosed carcinoma in situ of gastric and gastric cancer among 1,025,340 enrollees. Multiple logistic regression analysis was conducted to investigate the associations between independent variables and the rate of treatment with EMR. Results: Among 1671 gastric cancer patients, 317 (19.0 {\%}) subjects were treated with EMR. The ‘lowest’ income group was associated with a statistically significant lower rate of EMR treatment [odds ratio (OR) = 0.55, 95 {\%} confidence index (CI) 0.34–0.89] compared to the ‘highest’ income group. The ORs for the ‘low-middle’ and ‘middle-high’ income groups were both higher than for the reference group, although these were not significantly different. According to the subgroup analysis by gender, rate of EMR treatment of ‘lowest’ income group (OR = 0.37, 95 {\%} CI 0.18–0.74) was significantly lower only among men. Conclusion: In conclusion, we suggest that although universal health insurance in Korea has covered EMR treatment since August 2011, patients from the lowest income group are less likely to receive this treatment. Thus, we need to detect more eligible early-stage gastric cancer and treatment for individuals of low socioeconomic status.",
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Relationship between socioeconomic status and accessibility for endoscopic resection among gastric cancer patients : using National Health Insurance Cohort in Korea: poverty and endoscopic resection. / Kim, Na Yeon; Oh, Jun Seok; Choi, Young; Shin, Jaeyong; Park, Euncheol.

In: Gastric Cancer, Vol. 20, No. 1, 01.01.2017, p. 61-69.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship between socioeconomic status and accessibility for endoscopic resection among gastric cancer patients

T2 - using National Health Insurance Cohort in Korea: poverty and endoscopic resection

AU - Kim, Na Yeon

AU - Oh, Jun Seok

AU - Choi, Young

AU - Shin, Jaeyong

AU - Park, Euncheol

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Y1 - 2017/1/1

N2 - Background: Gastric cancer is one of the most common types of cancer among patients in Korea. We measured the inequity in accessibility to endoscopic mucosal/submucosal resection (EMR) for early and curable gastric cancer treatment among different income classes in patients diagnosed from late 2011 to 2013. Methods: Data were obtained from the National Health Insurance Cooperation Claim Data from patients diagnosed from late 2011 until the end of 2013, to provide a total of 1,671 patients with newly diagnosed carcinoma in situ of gastric and gastric cancer among 1,025,340 enrollees. Multiple logistic regression analysis was conducted to investigate the associations between independent variables and the rate of treatment with EMR. Results: Among 1671 gastric cancer patients, 317 (19.0 %) subjects were treated with EMR. The ‘lowest’ income group was associated with a statistically significant lower rate of EMR treatment [odds ratio (OR) = 0.55, 95 % confidence index (CI) 0.34–0.89] compared to the ‘highest’ income group. The ORs for the ‘low-middle’ and ‘middle-high’ income groups were both higher than for the reference group, although these were not significantly different. According to the subgroup analysis by gender, rate of EMR treatment of ‘lowest’ income group (OR = 0.37, 95 % CI 0.18–0.74) was significantly lower only among men. Conclusion: In conclusion, we suggest that although universal health insurance in Korea has covered EMR treatment since August 2011, patients from the lowest income group are less likely to receive this treatment. Thus, we need to detect more eligible early-stage gastric cancer and treatment for individuals of low socioeconomic status.

AB - Background: Gastric cancer is one of the most common types of cancer among patients in Korea. We measured the inequity in accessibility to endoscopic mucosal/submucosal resection (EMR) for early and curable gastric cancer treatment among different income classes in patients diagnosed from late 2011 to 2013. Methods: Data were obtained from the National Health Insurance Cooperation Claim Data from patients diagnosed from late 2011 until the end of 2013, to provide a total of 1,671 patients with newly diagnosed carcinoma in situ of gastric and gastric cancer among 1,025,340 enrollees. Multiple logistic regression analysis was conducted to investigate the associations between independent variables and the rate of treatment with EMR. Results: Among 1671 gastric cancer patients, 317 (19.0 %) subjects were treated with EMR. The ‘lowest’ income group was associated with a statistically significant lower rate of EMR treatment [odds ratio (OR) = 0.55, 95 % confidence index (CI) 0.34–0.89] compared to the ‘highest’ income group. The ORs for the ‘low-middle’ and ‘middle-high’ income groups were both higher than for the reference group, although these were not significantly different. According to the subgroup analysis by gender, rate of EMR treatment of ‘lowest’ income group (OR = 0.37, 95 % CI 0.18–0.74) was significantly lower only among men. Conclusion: In conclusion, we suggest that although universal health insurance in Korea has covered EMR treatment since August 2011, patients from the lowest income group are less likely to receive this treatment. Thus, we need to detect more eligible early-stage gastric cancer and treatment for individuals of low socioeconomic status.

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U2 - 10.1007/s10120-016-0597-1

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JF - Gastric Cancer

SN - 1436-3291

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