Cancer Res Treat.  2019 Jan;51(1):53-64. 10.4143/crt.2017.468.

Medical Travel among Non-Seoul Residents to Seek Prostate Cancer Treatment in Medical Facilities of Seoul

• Kim JH
• Kim SY
• Yun SJ
• Chung JI
• Choi H
• Yu HS
• Ha YS
• Cho IC
• Kim HJ
• Chung HC
• Koh JS
• Kim WJ
• Park JH
• Lee JY

• KMID: 2437598
• DOI: http://doi.org/10.4143/crt.2017.468

Abstract

PURPOSE
This study aims to investigate the trend in medical travel by non-Seoul residents to Seoul for treatment of prostate cancer and also to investigate the possible factors affecting the trend.
MATERIALS AND METHODS
This study represents a retrospective cohort study using data from theKoreanNationalHealth Insurance System from 2002 to 2015. Annual trends were produced for proportions of patients who traveled according to the age group, economic status and types of treatment. Multiple logistic analysiswas used to determine factors affecting surgeries at medical facilities in Seoul among the non-Seoul residents.
RESULTS
A total of 68,543 patients were defined as newly diagnosed prostate cancer cohorts from 2005 to 2014. The proportion of patients who traveled to Seoul for treatment, estimated from cases with prostate cancer-related claims, decreased slightly over 9 years (28.0 at 2005 and 27.0 at 2014, p=0.02). The average proportion of medical travelers seeking radical prostatectomy increased slightly but the increase was not statistically significant (43.1 at 2005 and 45.4 at 2014, p=0.26). Income level and performance ofrobot-assisted radical prostatectomy were significant positive factors for medical travel to medical facilities in Seoul. Combined comorbidity diseases and year undergoing surgery were significant negative factors for medical travel to medical facilities in Seoul.
CONCLUSION
The general trend of patients travelling from outside Seoul for prostate cancer treatment decreased from 2005 to 2014. However, a large proportion of traveling remained irrespective of direct distance from Seoul.

Keyword

Prostate; Neoplasms; Prostatectomy; Geography; Health Services Accessibility

MeSH Terms

Cohort Studies
Comorbidity
Geography
Health Services Accessibility
Humans
Insurance
Prostate*
Prostatectomy
Prostatic Neoplasms*
Retrospective Studies
Seoul*

Figure

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  Fig. 1. A flowchart illustrating the selection process of patients. NHIS, National Health Insurance Service; RP, radical prostatectomy; RARP, robot-assisted radical prostatectomy; ADT, androgen deprivation therapy.

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  Fig. 2. Utilization rate of medical facilities from first year after starting primary treatment by age (A), income level (B), and treatment type (C) among non-Seoul residents in prostate cancer-related claims. ADT, androgen deprivation therapy; RTx, radiation therapy.

Reference

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