OBJECTIVES : Patients with ovarian cancer (OC) after succeeding early treatment have a long observation period to monitor recurrence. Clinical guidelines recommend that patients over 2-year of disease-free survival need less frequent monitoring. This study aims to investigate OC-related healthcare utilization (HCU) and costs according to the frequency of outpatient visit in OC patients on the observation period.

METHODS : We conducted a descriptive, cross-sectional study using the national claims sample data of 2017, containing 3% of the total population in South Korea. We included patients with OC, having no claims for OC-related hospitalization in 2017. They were categorized into the infrequent and the frequent based on their number of OC-related outpatient visits for monitoring: less than 4 or not. HCU, including outpatient visit and monitoring, and OC-related direct costs were compared between two groups with focusing on imaging surveillance; magnetic resonance imaging, computed tomography, x-ray, ultrasonography and positron-emission tomography.

RESULTS : A total of 306 OC patients without OC-related hospitalization were identified. Those patients were classified as the frequent (N=47) and the infrequent group (N=259). The number of imaging for each visit were 1.139 and 1.135, respectively (p=0.882). The cost per visit for the frequent group (USD 458) was significantly higher than that of the infrequent group (USD 263, p<0.001). With focusing on imaging surveillance, computed tomography was preferred the most in both groups (58.5% of outpatient visits in the infrequent, 44.3% in the infrequent), and followed by X-rays for the frequent (37.7%) and ultrasonography, which is costly, for the infrequent group (30.4%), respectively.

CONCLUSIONS : Use of costly imaging surveillance in the frequent group was higher than that in the infrequent group. Although a further study needs to investigate factors that contribute to the difference such as patients’ characteristics, proper management is required to avoid unnecessary HCU and to reduce the burden of OC.