Impact of national health insurance on the survival rate of patients with osteosarcoma in Taiwan: review of 74 patients

The Kaohsiung Journal of Medical Sciences
Kein-Boon PoonGwo-Jaw Wang

Abstract

The 2-year survival rate for high-grade osteosarcoma was 46.9% before the introduction of National Health Insurance (NHI) in Taiwan on March 1, 1995, but increased to 73.8% after the implementation of NHI. The 5-year survival rate also increased, from 37.5% to 63.6%. Between May 1990 and May 2001, 74 patients with high-grade osteosarcoma were treated at our hospital. Median age was 17 years (range, 7-63 years). Inadequate surgical margins, poor histologic response to chemotherapy, advanced stage of disease, and incomplete treatment were strongly associated with poor prognosis. Before NHI, 10 patients had incomplete treatment, mainly because of unaffordable medical fees. After NHI, only three patients had incomplete treatment, due to personal reasons. Patient survival improved dramatically with advances in multiagent chemotherapy, but it was the NHI that enabled patients to complete expensive treatment courses, including preoperative neoadjuvant chemotherapy, limb-salvage surgery, and postoperative adjuvant chemotherapy. The NHI also improved the accessibility of medical care, with more patients presenting in the early stages of disease and, as a result, it not only improved survival rate but also increased the number of patient...Continue Reading

References

Jan 1, 1997·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·A J ProvisorJ S Miser
Jul 9, 1997·JAMA : the Journal of the American Medical Association·S H Cheng, T L Chiang
Nov 14, 1997·Annals of Oncology : Official Journal of the European Society for Medical Oncology·P PicciM Campanacci
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May 11, 2002·The Journal of Bone and Joint Surgery. British Volume·R J GrimerUNKNOWN Surgical Subcommitte of the European Osteosarcoma Intergroup

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Citations

Jun 18, 2011·International Journal of Clinical Oncology·Shih-Hsiang ChenIou-Jih Hung
Jun 12, 2012·World Journal of Surgical Oncology·Kok Long PanZainal Abidin
May 30, 2014·The American Journal of Chinese Medicine·Chien-Chung LinJer-Yuh Liu
Aug 1, 2015·The American Journal of Chinese Medicine·I-Chang ChangChia-Jen Lee
Mar 25, 2015·World Journal of Surgery·Juliet S OkorohRobert Riviello

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