{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T05:46:12Z","timestamp":1785649572396,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer imposes substantial clinical and financial burdens worldwide. Although Korea operates a universal National Health Insurance system, concerns remain regarding healthcare utilization and out\u2010of\u2010pocket (OOP) costs among cancer patients. This study compared healthcare utilization and OOP expenditure between adults with and without cancer in Korea and quantified adjusted differences associated with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were obtained from the 2023 Korea Health Panel Survey and included adults aged \u2265\u00a019 years. Healthcare utilization outcomes included outpatient visits, hospitalizations, emergency visits, total health encounters. OOP expenditures included inpatient, outpatient, emergency, pharmacy, and total annual healthcare expenditure. Survey\u2010weighted Poisson or negative binomial regression models and generalized linear models with gamma distribution and log link were used to estimate adjusted differences in healthcare utilization and OOP expenditures associated with cancer status after controlling for sociodemographic, socioeconomic, behavioral, insurance\u2010related, and clinical covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 10,911 participants, 626 (5.7%) reported a history of cancer and 10,285 (94.3%) had no history of cancer. Mean annual healthcare utilization was significantly higher among participants with cancer than those without cancer including hospitalization (0.78\u00a0vs. 0.19), outpatient visits (32.93\u00a0vs. 18.59), emergency visits (0.20\u00a0vs. 0.11), and total utilization (33.91\u00a0vs. 18.89) Cancer was independently associated with an adjusted difference of 8.93 total visits, 0.49 hospitalizations, 8.36 outpatient visits, and 0.08 emergency visits annually (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). OOP expenditure was substantially higher among cancer patients ($1,828\u00a0vs. $676;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), with significant adjusted differences in total OOP expenditure ($917), inpatient ($639), outpatient ($224), and pharmacy ($53). Lung ($2453), cervical ($1341), colorectal ($1113), and other cancers ($1201) showed the highest expenditure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cancer is associated with markedly greater healthcare utilization and significant OOP expenditure burden despite Korea's National Health Insurance (NHI) coverage. Strengthening financial protection, expanding coverage for high\u2010cost care, reinforcing OOP caps, and supporting vulnerable households are essential. Future longitudinal studies incorporating cancer stages, treatment pathways, and indirect costs are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajco.70142","type":"journal-article","created":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T05:03:58Z","timestamp":1785647038000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare Utilization and Out\u2010of\u2010Pocket Expenditure Among Adults With and Without Cancer in Korea\u2014Analysis of the Korea Health Panel Survey"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1522-1996","authenticated-orcid":false,"given":"Durga Datta","family":"Chapagain","sequence":"first","affiliation":[{"name":"Department of Global Health and Disease Control Yonsei University  Seoul Republic of Korea"},{"name":"Ministry of Health  Hetauda, Bagmati Province Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-2814","authenticated-orcid":false,"given":"Vasuki","family":"Rajaguru","sequence":"additional","affiliation":[{"name":"Department of Healthcare Management Graduate School of Public Health Yonsei University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4451-2285","authenticated-orcid":false,"given":"Do Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Seoul National University Bundang Hospital  Seongnam Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1053-8958","authenticated-orcid":false,"given":"Tae Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biohealth Industry Graduate School of Transdisciplinary Health Sciences Yonsei University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7183-0421","authenticated-orcid":false,"given":"Whiejong M.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Global Health and Disease Control Yonsei University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","unstructured":"\u201cGlobal Cancer Burden Growing Amidst Mounting Need for Services \u201dWorld Health Organization published February 1 2024 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