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Cited 2 time in webofscience Cited 3 time in scopus
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Fragmentation of care and colorectal cancer survival in South Korea: comparisons according to treatment at multiple hospitals

Authors
Choi, Dong-WooKim, SeungjuKim, Dong WookHan, Kyu-Tae
Issue Date
Sep-2022
Publisher
Springer Verlag
Keywords
Fragmented cancer care; Colorectal cancer; Five-year mortality; Healthcare utilization
Citation
Journal of Cancer Research and Clinical Oncology, v.148, no.9, pp 2323 - 2333
Pages
11
Indexed
SCIE
SCOPUS
Journal Title
Journal of Cancer Research and Clinical Oncology
Volume
148
Number
9
Start Page
2323
End Page
2333
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/919
DOI
10.1007/s00432-022-04035-9
ISSN
0171-5216
1432-1335
Abstract
Purpose Fragmented cancer care (FC) means that patients visit multiple providers for treatment, which is common in cancer care. While FC is associated with poor health outcomes in patients with colorectal cancer (CRC) worldwide, there is still a lack of evidence in South Korea. We investigated the association between FC and 5-year morality in patients with CRC using population-based claims data. Methods The study population was followed up from 2002 to 2015. Data were collected from Korea National Health Insurance claims. Participants comprised patients with CRC diagnosed with International Classification of Diseases (ICD)-10 (C18.x-C20.x) and a special claim code for cancer (V193). Data were analyzed using the Kaplan-Meier curve with a log-rank test and Cox proportional hazard model. The effect of FC on patients' 5-year survival was examined. Results Of 3467 patients with CRC, 20.0% had experienced FC. FC was significantly associated with an increased risk of 5-year mortality (hazard ratio 1.516, 95% confidence interval 1.274-1.804). FC was prevalent in those who had a low income level, underwent chemotherapy, did not undergo radiation therapy, and did not visit a tertiary hospital for their first treatment. Conclusion Efforts to decrease FC and integrate complex cancer care within appropriate healthcare delivery systems may improve survivorship among patients with CRC.
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자연과학대학 (정보통계학과)
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