Influence of Insurance Status on Survival of Surgically Treated Esophageal Cancer Patients

Yoo Hwa Hwang, Se Jin Oh, Jae Sung Choi, Ji Won Kim, Jeongsang Lee, Hyun Jong Moon

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background/Aims: Socioecomomic factor is an important determinant of access to healthcare and is one of the potential causes of disparities in esophageal cancer care outcomes. The aim of the study was to clarify the association between National health Insurance status (health insurance vs. medicare) as a socioeconomic factor and survival of patients with esophageal cancer who underwent surgical resection. Methods: Among the 66 patients who underwent surgical resection for esophageal cancer between January 2006 and December 2017, 17 patients (25.8%) were in the medicare group. The data were analyzed to identify clinical manifestations and to compare surgical and oncologic outcomes between the groups. Results: There was no significant difference in the distribution of sex (p=0.13), age (p=0.24), and pathologic stage (p=0.61) between the groups. The length of median hospital stay was significantly shorter in the healthy insurance group (18 days vs. 25 days, p=0.04). In the medicare group, postoperative mortality rates and incidence of postoperative complication were non-significantly higher(11.8% vs. 6.1%, p=0.45, 64.7% vs. 46.7%, p=0.21, respectively). However, pulmonary complication rates, including pneumonia, acute respiratory distress syndorme, and prolonged air leakage was significantly higher in the medicare group (47.1% vs. 18.4%, p=0.02). Five-year disease free survival rate was not different between the two groups (61.0% vs. 54.5%, p=0.68); the 5-year overall survival rate was significantly lower in the medicare group (27.7% vs. 53.7%, p=0.03). Conclusions: The medicare status of National health insurance could have a negative influence on the overall survival in patients with esophageal cancer who underwent surgery.

Original languageEnglish
Pages (from-to)15-20
Number of pages6
JournalThe Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
Volume72
Issue number1
DOIs
StatePublished - 25 Jul 2018

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Insurance Coverage
Esophageal Neoplasms
Medicare
Survival
National Health Programs
Survival Rate
Sex Distribution
Health Insurance
Insurance
Health Status
Disease-Free Survival
Length of Stay
Pneumonia
Air
Delivery of Health Care
Lung
Mortality
Incidence

Keywords

  • Esophageal neoplasm
  • Insurance coverage
  • Surgery
  • Survival

Cite this

@article{f688ecf4146146068b7036d754fd27d8,
title = "Influence of Insurance Status on Survival of Surgically Treated Esophageal Cancer Patients",
abstract = "Background/Aims: Socioecomomic factor is an important determinant of access to healthcare and is one of the potential causes of disparities in esophageal cancer care outcomes. The aim of the study was to clarify the association between National health Insurance status (health insurance vs. medicare) as a socioeconomic factor and survival of patients with esophageal cancer who underwent surgical resection. Methods: Among the 66 patients who underwent surgical resection for esophageal cancer between January 2006 and December 2017, 17 patients (25.8{\%}) were in the medicare group. The data were analyzed to identify clinical manifestations and to compare surgical and oncologic outcomes between the groups. Results: There was no significant difference in the distribution of sex (p=0.13), age (p=0.24), and pathologic stage (p=0.61) between the groups. The length of median hospital stay was significantly shorter in the healthy insurance group (18 days vs. 25 days, p=0.04). In the medicare group, postoperative mortality rates and incidence of postoperative complication were non-significantly higher(11.8{\%} vs. 6.1{\%}, p=0.45, 64.7{\%} vs. 46.7{\%}, p=0.21, respectively). However, pulmonary complication rates, including pneumonia, acute respiratory distress syndorme, and prolonged air leakage was significantly higher in the medicare group (47.1{\%} vs. 18.4{\%}, p=0.02). Five-year disease free survival rate was not different between the two groups (61.0{\%} vs. 54.5{\%}, p=0.68); the 5-year overall survival rate was significantly lower in the medicare group (27.7{\%} vs. 53.7{\%}, p=0.03). Conclusions: The medicare status of National health insurance could have a negative influence on the overall survival in patients with esophageal cancer who underwent surgery.",
keywords = "Esophageal neoplasm, Insurance coverage, Surgery, Survival",
author = "Hwang, {Yoo Hwa} and Oh, {Se Jin} and Choi, {Jae Sung} and Kim, {Ji Won} and Jeongsang Lee and Moon, {Hyun Jong}",
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Influence of Insurance Status on Survival of Surgically Treated Esophageal Cancer Patients. / Hwang, Yoo Hwa; Oh, Se Jin; Choi, Jae Sung; Kim, Ji Won; Lee, Jeongsang; Moon, Hyun Jong.

In: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi, Vol. 72, No. 1, 25.07.2018, p. 15-20.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Influence of Insurance Status on Survival of Surgically Treated Esophageal Cancer Patients

AU - Hwang, Yoo Hwa

AU - Oh, Se Jin

AU - Choi, Jae Sung

AU - Kim, Ji Won

AU - Lee, Jeongsang

AU - Moon, Hyun Jong

PY - 2018/7/25

Y1 - 2018/7/25

N2 - Background/Aims: Socioecomomic factor is an important determinant of access to healthcare and is one of the potential causes of disparities in esophageal cancer care outcomes. The aim of the study was to clarify the association between National health Insurance status (health insurance vs. medicare) as a socioeconomic factor and survival of patients with esophageal cancer who underwent surgical resection. Methods: Among the 66 patients who underwent surgical resection for esophageal cancer between January 2006 and December 2017, 17 patients (25.8%) were in the medicare group. The data were analyzed to identify clinical manifestations and to compare surgical and oncologic outcomes between the groups. Results: There was no significant difference in the distribution of sex (p=0.13), age (p=0.24), and pathologic stage (p=0.61) between the groups. The length of median hospital stay was significantly shorter in the healthy insurance group (18 days vs. 25 days, p=0.04). In the medicare group, postoperative mortality rates and incidence of postoperative complication were non-significantly higher(11.8% vs. 6.1%, p=0.45, 64.7% vs. 46.7%, p=0.21, respectively). However, pulmonary complication rates, including pneumonia, acute respiratory distress syndorme, and prolonged air leakage was significantly higher in the medicare group (47.1% vs. 18.4%, p=0.02). Five-year disease free survival rate was not different between the two groups (61.0% vs. 54.5%, p=0.68); the 5-year overall survival rate was significantly lower in the medicare group (27.7% vs. 53.7%, p=0.03). Conclusions: The medicare status of National health insurance could have a negative influence on the overall survival in patients with esophageal cancer who underwent surgery.

AB - Background/Aims: Socioecomomic factor is an important determinant of access to healthcare and is one of the potential causes of disparities in esophageal cancer care outcomes. The aim of the study was to clarify the association between National health Insurance status (health insurance vs. medicare) as a socioeconomic factor and survival of patients with esophageal cancer who underwent surgical resection. Methods: Among the 66 patients who underwent surgical resection for esophageal cancer between January 2006 and December 2017, 17 patients (25.8%) were in the medicare group. The data were analyzed to identify clinical manifestations and to compare surgical and oncologic outcomes between the groups. Results: There was no significant difference in the distribution of sex (p=0.13), age (p=0.24), and pathologic stage (p=0.61) between the groups. The length of median hospital stay was significantly shorter in the healthy insurance group (18 days vs. 25 days, p=0.04). In the medicare group, postoperative mortality rates and incidence of postoperative complication were non-significantly higher(11.8% vs. 6.1%, p=0.45, 64.7% vs. 46.7%, p=0.21, respectively). However, pulmonary complication rates, including pneumonia, acute respiratory distress syndorme, and prolonged air leakage was significantly higher in the medicare group (47.1% vs. 18.4%, p=0.02). Five-year disease free survival rate was not different between the two groups (61.0% vs. 54.5%, p=0.68); the 5-year overall survival rate was significantly lower in the medicare group (27.7% vs. 53.7%, p=0.03). Conclusions: The medicare status of National health insurance could have a negative influence on the overall survival in patients with esophageal cancer who underwent surgery.

KW - Esophageal neoplasm

KW - Insurance coverage

KW - Surgery

KW - Survival

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