Results
Table 1 shows the general characteristics of the study population. In our study, we included 7,317 patients, of whom 27.8% were leukemia patients, 15.2% were brain and central nervous system cancer patients, 9.2% were non-Hodgkin’s lymphoma patients, 7.0% were bone and articular cartilage cancer patients, 5.1% were mesothelioma soft tissue cancer patients, and 35.8% were ‘other’ cancer patients.
Table 2 displays the average medical cost incurred by childhood cancer survivors from the time of initial diagnosis until the end of the next 5 years. The total medical cost per patient is 36.8 million KRW (USD 30,665). Inpatient services cost 28.3 million KRW (USD 23,600), whereas outpatient services cost 8 million KRW (USD 7,078). When classified by cancer type, leukemia was associated with the highest cost at 53.5 million KRW (USD 44,556) followed by bone and articular cartilage cancer at 52.0 million KRW (USD 43,374) (Supplementary table 1).
Results of a regression analysis on total medical costs for childhood cancer survivors are presented in Table 3. Patients undergoing chemotherapy, radiotherapy, and surgery bore higher medical costs compared with those who did not receive major treatments. When analyzed according to socioeconomic status, the medical cost was greater in patients of higher socioeconomic status. This result was unaffected by cancer type (Supplementary table 2). To investigate the duration of services received, regression analyses on the number of days of medical service use was performed (Table 4). Leukemia patients used medical services for a longer duration (104.0 days) compared to any other childhood cancer patients in both inpatient (67.4 days) and outpatient (36.6 days) service categories.
Figure 1 demonstrates the medical costs borne by childhood cancer survivors, based on their socioeconomic status, in each treatment phase and the cumulative medical cost. Medical costs for patients were high in the early phase of treatment. When analyzed according to socioeconomic status, increased medical costs were observed in the first 3 months following diagnosis for the high status category. The medical costs based on socioeconomic status are as follows: low status at 11.7 million KRW (USD 9,776); mid-low at 12.1 million KRW (USD 10,116); mid-high at 12.2 million KRW (USD 11,083); and high at 15.0 million KRW (USD 12,508) for the same treatment phase. The cumulative costs classified according to cancer types are presented in Supplementary table 3.