KMID : 0191120210360290194
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Journal of Korean Medical Science 2021 Volume.36 No. 29 p.194 ~ p.194
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Changes in Korean National Healthcare Insurance Policy and Breast Cancer Surgery Trend in Korea
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Rayzah Musaed
Ryu Jai-Min Lee Jun-Hee Nam Seok-Jin Kim Seok-Won Lee Se-Kyung Yu Jong-Han Lee Kyeong-Tae Bang Sa-Ik Mun Goo-Hyun Pyon Jai-Kyong Jeon Byung-Joon Lee Jeong-Eon
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Abstract
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Background: Since April 2015, the Korean National Health Insurance (NHI) has reimbursed breast cancer patients, approximately 50% of the cost of the breast reconstruction (BR) procedure. We aimed to investigate NHI reimbursement policy influence on the rate of immediate BR (IBR) following total mastectomy (TM).
Methods: We retrospectively analyzed breast cancer data between April 2011 and June 2016. We divided patients who underwent IBR following TM for primary breast cancer into ¡°uninsured¡± and ¡°insured¡± groups using their NHI statuses at the time of surgery. Univariate analyses determined the insurance influence on the decision to undergo IBR.
Results: Of 2,897 breast cancer patients, fewer uninsured patients (n = 625) underwent IBR compared with those insured (n = 325) (30.0% vs. 39.8%, P < 0.001). Uninsured patients were younger than those insured (median age [range], 43 [38?48] vs. 45 [40?50] years; P < 0.001). Pathologic breast cancer stage did not differ between the groups (P = 0.383). More insured patients underwent neoadjuvant chemotherapy (P = 0.011), adjuvant radiotherapy (P < 0.001), and IBR with tissue expander insertion (P = 0.005) compared with those uninsured.
Conclusion: IBR rate in patients undergoing TM increased after NHI reimbursement.
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KEYWORD
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Breast Cancer, Breast Reconstruction, Insurance, Subcutaneous Mastectomy
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