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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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