암환자의 진단-치료 소요기간에 따른 생존분석과 지역사회별 격차 및 시계열적 추이 (The Impact of Time-to-Treatment for Outcome in Cancer Patients, and Its Differences by Region and Time Trend)

서지정보

· 발행기관 : 한국보건행정학회
· 수록지 정보 : 보건행정학회지 / 31권 / 1호 / 91 ~ 99페이지
· 저자명 : 김우림, 한규태

초록

Background: The Korean government introduced National Cancer Control Program and strengthening national health insurancecoverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancermanagement such as patient concentration or time-to-treatment. Thus, we investigated the association between thetime-to-treatment and survival of cancer patients, and compared regional differences by time trend.
Methods: The data used in this study were national health insurance claims data that included patients diagnosed with lung cancerand received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for theassociation between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences fortime-to-treatment by time trend.
Results: A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, butit was generally reduced after 2010.
Conclusion: Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improvecancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity andtypes of cancer.

영어초록

Background: The Korean government introduced National Cancer Control Program and strengthening national health insurancecoverage for cancer patients. Although many positive effects have been observed, there are also many concerns about cancermanagement such as patient concentration or time-to-treatment. Thus, we investigated the association between thetime-to-treatment and survival of cancer patients, and compared regional differences by time trend.
Methods: The data used in this study were national health insurance claims data that included patients diagnosed with lung cancerand received surgical treatment between 2005 and 2015. We conducted survival analysis with Cox proportional hazard model for theassociation between time-to-treatment and survival in lung cancer. Additionally, we compared the regional differences fortime-to-treatment by time trend.
Results: A total of 842 lung cancer patients were included, and 52.3% of lung cancer patients received surgical treatment within 30days. Patients who received surgical treatment after 31 days had higher 5-year or 1-year mortality compared to treatment within 30days (5-year: hazard ratio [HR], 1.566; 1-year: HR, 1.555; p<0.05). There were some regional differences for time-to-treatment, butit was generally reduced after 2010.
Conclusion: Delayed surgical treatment after diagnosis can negatively affect patient outcomes in cancer treatment. To improvecancer control strategies, there are needed to analyze the healthcare delivery system for cancer care considering the severity andtypes of cancer.

참고자료

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