The determinants of purchasing private health insurance in Korean cancer patients

Objectives: The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance (NHI) system in Korea. Methods: The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung (C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. Results: Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of L65,311 and an average benefit amount of L19million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. Conclusions: About half of Korean people have supplementary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.