2012 ©
             Publication
Journal Publication
Title of Article Health Insurance and Colorectal Cancer Survival in Khon Kaen, Thailand 
Date of Acceptance 4 June 2019 
Journal
     Title of Journal Asian Pacific Journal of Cancer Prevention 
     Standard SCOPUS 
     Institute of Journal the Asian Pacific Organization for Cancer Prevention (APOCP) 
     ISBN/ISSN  
     Volume 20 
     Issue
     Month
     Year of Publication 2019 
     Page  
     Abstract Background: Evidence from healthcare studies demonstrates that patients’ health insurance affects service accessibility and the outcome of treatment. However, assessment on how colorectal cancer survival relates to health insurance is limited. Objective: The study examined the association between health insurance and colorectal cancer survival in Khon Kaen, Thailand. Methods: The retrospective cohort study was conducted with 1,931 colorectal cancer patients from Khon Kaen cancer registry between January 1, 2003 and December 31, 2012, and was followed-up until December 31, 2015. Relative survival was used to estimate the survival rate. Cox proportional hazard regression was used to estimate the relationship between health insurance and colorectal cancer survival, represented with the hazard ratio. Result: Most of the participants were males, and the median age was 62 years. The median survival time was 2.25 years (95% CI: 2.00-2.51). The five-year observed survival rate and relative survival rate were 36.87 (95% CI: 34.66-39.08) and, 42.28 (95% CI: 39.75-44.81), respectively. The factors that showed significant associations with poorer survival after adjustment for gender and age were non-surgical treatments (HRadj=1.88;95%CI=1.45-2.45), advanced stage (III+IV) (HRadj=2.50; 95%CI=2.00-3.12), histological grading in poorly differentiated (HRadj=1.84; 95%CI=1.32-2.56), and Universal Coverage Scheme (HRadj=1.37;95%CI=1.09-1.72). Conclusion: The survival of colorectal cancer patients in the Universal Coverage Scheme was likely to be poorer than in the Civil Servant Medical Benefit Scheme. This indicates an urgent need for a national program for colorectal cancer screening in the general population and access to health insurance. 
     Keyword Health insurance- colorectal cancer- relative survival 
Author
597110020-4 Mr. SURACHAI PHIMHA [Main Author]
Public Health Doctoral Degree

Reviewing Status มีผู้ประเมินอิสระ 
Status ได้รับการตอบรับให้ตีพิมพ์ 
Level of Publication นานาชาติ 
citation false 
Part of thesis true 
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