臨牀消化器内科 Vol.31 No.2(4-6)


特集名 有効性評価に基づく胃がん検診ガイドライン―内視鏡検診時代の新たなる幕開け
題名 胃内視鏡検診を巡る新たなる展開 (6) 韓国のNational Cancer Screening Program
発刊年月 2016年 02月
著者 後藤 励 京都大学白眉センター・経済学研究科
【 要旨 】 韓国の公的がん検診は,単一の保険者である国民健康保険公団との綿密な協力の下に行われている.胃がん検診の受診率は70%を超え,検診の中心は内視鏡検診にすでに移っている.一方,健康保険の給付範囲は日本より狭く,公的がん検診で発見された癌には治療費の補助を行うため,受診者にとっても公的がん検診受診のインセンティブが大きい.また,診療報酬請求に対する審査も厳しいため,保険診療上で癌を疑った検査を幅広い患者に行うことが難しい.日本では,多数の保険者が検診を行っており,健康保険の給付の範囲も広いため公的がん検診の代替物が多数存在する.内視鏡検診の普及を進めていくには,日本の保険診療の特徴にも留意した施策が必要となる.
Theme Evidence-based Guidelines Version 2 for Gastric Cancer Screening ; The Beginning of a New Era of Endoscopic Cancer Screening
Title National Cancer Screening Program in Korea
Author Rei Goto Hakubi Center of Advanced Research, Graduate School of Economics
[ Summary ] Korea provides population‒based screening programs. However, the screening rates are much higher in Korea than in Japan. Population‒based cancer screening in Korea is coordinated well with social health insurance under a unified system. The screening rate of cancer is over 70 %, which is much higher than that in Japan. In Korea, public healthcare does not cover a wide range of services. Nearly free cancer screening and subsidized medical expenses for cancers detected by population‒based screening provides a high incentive for participation. In Japan, in contrast, greater coverage of medical services, low co‒payments, and a lenient medical audit enables cancer screening under public health insurance and also covers a broad range of cancer screening. The implementation of evidence‒based cancer screening programs may be largely dependent on the prevailing healthcare system. Understanding the impacts of each healthcare system as a whole and matching the characteristics of a particular healthcare system is important when designing an efficient cancer screening program.
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