OBJECTIVES

Cancer is one of leading causes of death among women and surgery is a gold standard to treat cancer. Due to an aging global population, the cost related to cancer surgery is also increasing worldwide. We estimated health care utilization and hospitalization cost of cancers that most often affect women using real world data from Korea.

METHODS

We analyzed medical claims of women who received surgery for thyroid, breast, endometrial, or cervical cancer using 2016 National Patient Sample (NIS) dataset of Health Insurance Review and Assessment Service (HIRA). Patients who were hospitalized with claims of both cancer diagnoses and surgery procedure codes were included for analysis. Categorization of patients was based on their main diagnoses and patients with multiple surgeries were excluded from the analysis.

RESULTS

A total of 5,087 women patients were identified of which age was 50.6 ± 11.9. The number of breast surgery patients (N=2,685) was the largest followed by thyroid (N=2,140), hysterectomy for cervical (N=161) and for endometrial (N=101) cancer. Length of stay was much shorter in thyroidectomy (5.9 days) than mastectomy (9 days), followed by hysterectomy for endometrial (10.2 days) and cervical cancer (12.2 days). Total cost of the entire hospitalization period also followed the same order. Total cost from admission to discharge was USD 2,585 for thyroidectomy, USD 4,066 for mastectomy, USD 4,615 for hysterectomy-endometrial and USD 4,853 for hysterectomy-cervical cancer. Patients’ payment was the largest in mastectomy of USD 975, which was 1.47-1.68 times higher than that of the surgeries for the other cancers. The trend of patients and surgery concentrating in high volume hospitals appeared more evident in mastectomy and hysterectomy for endometrial cancer compared to cervical cancer and thyroidectomy

CONCLUSIONS

The cost of women’s cancer surgery in Korea is substantial and total cost increases with an extended length of stay.