The effect of extension of benefit coverage for cancer patients on health care utilization across different income groups in South Korea

  • Sujin Kim
  • Soonman KwonEmail author


To provide financial protection against catastrophic illness, the Korean government expanded the National Health Insurance (NHI) benefit coverage for cancer patients in 2005. This paper examined whether the policy improved the income-related equality in health care utilization. This study analyzed the extent to which the policy improved income-related equality in outpatient visits, inpatient days, and inpatient and outpatient care expenditure based on triple difference estimator. Using nationwide claims data of the NHI from 2002 to 2004 and from 2006 to 2010, we compared cancer patients as a treatment group with liver disease as a control group and low-income group with the highest-income group. The results showed that the extension of NHI benefits coverage led to an increase in the utilization of outpatient services across all income groups, but with a greater increase for the low-income groups, among cancer patients. Moreover, the policy led to a less decrease in the utilization of inpatient services for the low-income group while it decreased across all income groups. Our finding suggests that the extension of NHI benefits coverage improved the income-related equality in health care utilization.


Health care utilization Cancer Universal coverage Income-related equality South Korea 

JEL Classification

I13 I14 I18 



This study was funded by the National Evidence-based Healthcare Collaborating Agency (NECA), Project No. NM2011-001, and approved by the Institutional Review Board of the same institute. We thank the NECA and also acknowledge support from the National Health Insurance Corporation that provided the data for our study. The anonymous reviewer and the editor of this journal provided insightful comments. We would like to thank Juhwan Oh, Hongsoo Kim and Youn Jung for their comments and supports.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.School of Public HealthSeoul National UniversitySeoul South Korea
  2. 2.National Evidence-based Healthcare Collaborating AgencySeoulSouth Korea

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