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Open Access Research article

Impact of supplementary private health insurance on stomach cancer care in Korea: a cross-sectional study

Dong Wook Shin1, Kee-Taig Jung2, Sung Kim3, Jae-Moon Bae3, Young-Woo Kim1, Keun Won Ryu1, Jun Ho Lee1, Jae-Hyung Noh3, Tae-Sung Sohn3 and Young Ho Yun1*

Author Affiliations

1 National Cancer Control Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi, Korea

2 Department of Health Services Management, Kyung Hee University, Seoul, Korea

3 Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea

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BMC Health Services Research 2009, 9:133  doi:10.1186/1472-6963-9-133

Published: 31 July 2009

Abstract

Background

Korea achieved universal health insurance coverage in only 12 years; however, insufficient government funding has resulted in high out-of-pocket payments and, in turn, a demand for supplementary private health insurance (PHI). Supplementary PHI provides a fixed amount of benefits in the event of critical illness (e.g., cancer or stroke), surgery, or hospitalization. In this study, we tried to identify factors that influence the decision to purchase supplementary PHI and investigate the impacts of PHI on various aspects of cancer care.

Methods

In a cross-sectional study of 391 patients with gastric cancer, we collected data on demographic and clinical variables, coverage by PHI at the time of diagnosis, and patients' cancer care experiences from surgery databases and patient questionnaires. Two separate multivariate logistic regression models were used 1) to determine whether various sociodemographic and clinical variables influence the purchase of supplementary PHI, and 2) to determine if there is a difference in various outcome measures between individuals with and without PHI.

Results

We studied 187 subjects (49.6%) who were covered under PHI at the time of diagnosis. Subjects who purchased PHI tended to be younger (aOR = 5.01, 95% C.I. = 2.05 – 12.24), and more educated (aOR = 2.67, 95% C.I. = 1.04 – 6.86). Supplementary PHI coverage was significantly associated with financial independence (aOR = 2.07, 95% CI = 1.19 – 3.61), but not with other aspects of cancer care, such as access to healthcare, quality of care, communication and patient autonomy.

Conclusion

Our findings demonstrate that supplementary PHI neither serves as a safety net for vulnerable patients nor improves cancer care experience, except for maintaining the financial independence of beneficiaries.