Disparities in the Diagnosis and Treatment of Bile Duct Cancer in People with Disabilities: A National Cohort Study in South Korea

Seon Mee Park, So Young Kim, Kyoung Eun Yeob, Dong Wook Shin, Joung-Ho Han, Jong Heon Park and Jong Hyock Park ()
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Seon Mee Park: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
So Young Kim: Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju 28644, Korea
Kyoung Eun Yeob: Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, Korea
Dong Wook Shin: Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul 06351, Korea
Joung-Ho Han: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
Jong Heon Park: Big Data Steering Department, National Health Insurance Service, Wonju 26464, Korea
Jong Hyock Park: Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, Korea

IJERPH, 2022, vol. 19, issue 24, 1-14

Abstract: We aimed to evaluate the impacts of disability on the diagnosis, treatment, and prognosis of bile duct cancer (BDC) according to the severity and type of disability. Patients diagnosed with BDC were selected from an age- and sex-matched population (1:3 ratio) with or without disabilities from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claims database. The cohort included 15,065 patients with BDC, with a significantly lower rate in those with severe disabilities than in people without or with mild disabilities (110.6 vs. 136.5 vs. 147.6 per 105 persons, respectively). People with severe disabilities were diagnosed with BDC at an earlier age but were less likely to undergo surgery (adjusted odds ratio (aOR) = 0.52, 95% confidence interval (CI): 0.45–0.61) or chemotherapy (aOR = 0.76, 95% CI: 0.61–0.95) compared to those without disabilities. This trend was more evident in patients with mental disabilities. The overall and cancer-specific mortality rates were higher in patients (especially women) with disabilities than in those without. There needs systemic approach to ensure equal access to quality cancer care for people with disabilities.

Keywords: bile duct cancer; disability; stage; treatment; survival (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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