Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals

Background: This study aimed to examine out-of-pocket expenditure for cancer treatments of hospitalizedpatients and to analyze changing patterns over time. Materials and
Methods: This study examined data ofall cancer patients receiving inpatient care from two tertiary hospitals from January 2003 to December 2010.Medical expenditures per admission were calculated and classified into those covered and uncovered by theKorean National Health Insurance (NHI) and co-payment.
Results: The medical expenditure per admissionincreased slowly from 3,455 thousand Korean won (KRW) to 4,068 thousand KRW. While expenditures coveredby the NHI have increased annually, co-payments have generally decreased. The out-of-pocket expenditureratio, which means the proportion of uncovered expenditure and co-payment among total medical expendituredropped sharply from 2005 to 2007 and was maintained at a similar level after 2007. Medical expenditures, NHIcoverage, and the out-of-pocket expenditure ratio differed across cancer types.
Conclusions: It is necessary tocontinually monitor the expenditure of uncovered services by the NHI, and to provide policies to reduce thiseconomic burden. In addition, an individual approach considering cancer type-specific characteristics andmedical utilization should be provided.