Asia-Pacific journal of clinical oncology
August 1, 2026 · via Europe PMC
Healthcare Utilization and Out-of-Pocket Expenditure Among Adults With and Without Cancer in Korea-Analysis of the Korea Health Panel Survey.
Chapagain DD, Rajaguru V, Kim DH, Kim TH, Han WM
AI summary — for doctors, generated from the abstract only
Korean adults with cancer used much more healthcare and paid significant out-of-pocket costs despite universal insurance.
What was studied
A cross-sectional analysis of the 2023 Korea Health Panel Survey (10,911 adults, 5.7% with cancer history) comparing utilization and out-of-pocket spending with adjusted models.
Key findings
- Annual hospitalizations were 0.78 versus 0.19, outpatient visits 32.93 versus 18.59, and emergency visits 0.20 versus 0.11
- Cancer was independently associated with about 8.93 more total visits and 0.49 more hospitalizations annually
- Out-of-pocket expenditures were significantly higher for people with cancer
Clinical relevance
It reminds clinicians that financial toxicity exists even under universal coverage.
Who should care
Limitations
A self-reported cross-sectional survey without stage, treatment or indirect costs, so causation and detail are limited.
Screen for financial burden and connect patients with support services.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
Cancer imposes substantial clinical and financial burdens worldwide. Although Korea operates a universal National Health Insurance system, concerns remain regarding healthcare utilization and out-of-pocket (OOP) costs among cancer patients. This study compared healthcare utilization and OOP expenditure between adults with and without cancer in Korea and quantified adjusted differences associated with cancer.
METHODS
Data were obtained from the 2023 Korea Health Panel Survey and included adults aged ≥ 19 years. Healthcare utilization outcomes included outpatient visits, hospitalizations, emergency visits, total health encounters. OOP expenditures included inpatient, outpatient, emergency, pharmacy, and total annual healthcare expenditure. Survey-weighted Poisson or negative binomial regression models and generalized linear models with gamma distribution and log link were used to estimate adjusted differences in healthcare utilization and OOP expenditures associated with cancer status after controlling for sociodemographic, socioeconomic, behavioral, insurance-related, and clinical covariates.
RESULTS
Among 10,911 participants, 626 (5.7%) reported a history of cancer and 10,285 (94.3%) had no history of cancer. Mean annual healthcare utilization was significantly higher among participants with cancer than those without cancer including hospitalization (0.78 vs. 0.19), outpatient visits (32.93 vs. 18.59), emergency visits (0.20 vs. 0.11), and total utilization (33.91 vs. 18.89) Cancer was independently associated with an adjusted difference of 8.93 total visits, 0.49 hospitalizations, 8.36 outpatient visits, and 0.08 emergency visits annually (all p < 0.001). OOP expenditure was substantially higher among cancer patients ($1,828 vs. $676; p < 0.001), with significant adjusted differences in total OOP expenditure ($917), inpatient ($639), outpatient ($224), and pharmacy ($53). Lung ($2453), cervical ($1341), colorectal ($1113), and other cancers ($1201) showed the highest expenditure.
CONCLUSION
Cancer is associated with markedly greater healthcare utilization and significant OOP expenditure burden despite Korea's National Health Insurance (NHI) coverage. Strengthening financial protection, expanding coverage for high-cost care, reinforcing OOP caps, and supporting vulnerable households are essential. Future longitudinal studies incorporating cancer stages, treatment pathways, and indirect costs are warranted.
DOI
10.1111/ajco.70142
PMID
42542563
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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