The Economic Burden of Breast Cancer Survivors in Korea: A Descriptive Study Using a 26-Month Micro-Costing Cohort Approach

Document Type: Research Articles


1 Graduate School of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea.

2 Department of Public Health, Daegu Haany University, 1 Haanydaero, Gyeongsan, Korea.

3 Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul, Korea.


Background: This study analyzed the burden of cancer treatment costs on patients by calculating the monthly
amount of medical expenses paid by breast cancer patients for two years after mastectomy. Methods: Among those
who were diagnosed with breast cancer and had received treatment at one of two academic medical centers in Seoul
between 2003 and 2011, 1,087 patients who underwent mastectomy and received follow-up for at least two years
were recruited. A micro-costing approach from the provider’s perspective, based on a retrospective review of patient
medical claim records, was used to analyze cancer treatment cost of care. The cohort’s number of hospitalizations,
total hospitalization duration, and number of outpatient visits were noted, and the total amount of medical expenses,
out-of-pocket (OOP) expenditures, uninsured costs, and OOP ratio were calculated. Results: The total amount of
medical expenses tended to increase by year, whereas the OOP expenditure ratio decreased. The OOP expenditure
ratio was highest in the first month post-operation. Around one quarter of the total OOP payments incurred over the
course of three months: one month before the operation, the month of the operation, and one month post-operation.
Conclusion: OOP payment burden on patients was concentrated in the initial phase of treatment, and items not covered
by the National Health Insurance caused an additional increase in patients’ burden in the initial phase. The economic
burden of cancer treatment varies considerably. In order to alleviate patients’ medical expenses burden, the timing of
expenditures and the possible financial burden on cancer survivors, they should be understood more fully and possibly
addressed in interventions aimed at reducing the cancer burden.


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