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Association between Moving to a High-Volume Hospital in the Capital Area and the Mortality among Patients with

Jung-Kyu Choi1, Se-Hyung Kim2, Myung-Bae Park3

  • 1Institute of Health Insurance & Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea.

International Journal of Environmental Research and Public Health
|April 30, 2021
PubMed

Insights

Cancer patients traveling to Seoul for treatment had higher mortality risks. Female cancer patients and wealthier individuals in the province showed better survival rates, highlighting disparities in cancer care.

Area of Science:

  • Oncology
  • Health Services Research
  • Epidemiology

Background:

  • Cancer patient outcomes can be influenced by healthcare access and socioeconomic factors.
  • Geographic location of treatment facilities may impact cancer mortality rates.
  • Disparities in cancer care exist based on gender, income, and healthcare utilization patterns.

Purpose of the Study:

  • To investigate the association between utilizing high-volume hospitals (Seoul) and cancer patient mortality.
  • To identify demographic and socioeconomic factors influencing cancer survival.
  • To explore disparities in cancer care and outcomes within a defined district.

Main Methods:

  • Retrospective cohort study of 8197 cancer patients (2004-2012).
  • Cox proportional hazard model used to estimate hazard ratios (HR) for mortality.
  • Analysis adjusted for confounding variables: sex, age, social security, income, disability, and utilization volume.

Main Results:

  • Overall mortality rate was approximately 10% during the follow-up period.
  • Female cancer patients had a lower hazard ratio for death (HR: 0.68) compared to males.
  • Patients utilizing healthcare services in Seoul had a higher hazard ratio for death (HR: 1.30) than those not using Seoul services.
  • Wealthier patients utilizing services within the province had significantly higher survival probabilities.

Conclusions:

  • Healthcare seeking behavior, particularly travel to high-volume centers like Seoul, is associated with increased cancer mortality.
  • Significant survival disparities exist among cancer patients based on gender and socioeconomic status.
  • Addressing income-related disparities and enhancing medical accessibility for low-income families are crucial for reducing cancer mortality.

Keywords:
cancerincomemortalitypatient movement

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