Disparities in utilization of high-volume hospitals for cancer surgery: Results of a Korean population-based study

So Young Kim, Jong Hyock Park, Sung Gyeong Kim, Hye Kyung Woo, Jae Hyun Park, Yoon Kim, Eun Cheol Park

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Background: Referral to high-volume hospitals has been recommended for cancer procedures with a demonstrated volume-outcome relationship. However, little is known about the factors associated with use of high-volume hospitals for cancer procedures. The purpose of this study was to determine patient characteristics associated with receipt of oncologic surgery at high-volume hospitals. Methods: Data were obtained from claims submitted to the Korean National Health Insurance System. We identified patients who underwent the following procedures between 2002 and 2005: esophagectomy, pancreatectomy, gastrectomy, colectomy, lung resection, mastectomy, and cystectomy. Each hospital volume was divided into tertiles. Patient demographic, socioeconomic, and clinical variables were investigated as factors that may affect use of high- or low-volume hospitals. Results: A total of 49,897 patients received one of the seven procedures. Trends toward lower operative risks at high-volume hospitals were observed for all procedures. Patients who were older [odds ratio (OR), 0.60-0.69], lived in a rural area (OR, 0.79), had emergent surgeries (OR, 0.39-0.85), and had lower Charlson score were less likely to go to high-volume hospitals. For all procedures, patients having the lowest income level were significantly less likely to be treated at high-volume hospitals, compared with patients having the highest income level (OR, 0.45-0.58). Conclusions: We identified substantial demographic and socioeconomic disparities in use of high-volume hospitals for the seven procedures examined. The policy for selective referral to high-volume hospitals should include explicit efforts to identify patient and system factors required to reduce current inequities.

Original languageEnglish
Pages (from-to)2806-2815
Number of pages10
JournalAnnals of surgical oncology
Issue number11
Publication statusPublished - 2010 Nov

Bibliographical note

Funding Information:
ACKNOWLEDGMENT This work was supported by a grant from the National Cancer Center, Korea (no. 0910191).

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology


Dive into the research topics of 'Disparities in utilization of high-volume hospitals for cancer surgery: Results of a Korean population-based study'. Together they form a unique fingerprint.

Cite this