Still lost in transition? Perspectives of ongoing cancer survivorship care needs in South Korea

Background

Despite the establishment of legal frameworks and the expansion of regional centers, South Korea’s cancer survivorship care delivery system continues to face functional gaps during the transition to community-based, integrated care. We investigated the structural causes of this perceived implementation gap by comparing expert perceptions between the policy inception phase (2013) and the diffusion phase (2022).

Methods

A comparative Delphi design was employed to examine temporal changes in expert consensus regarding the care delivery system. Data from two independent expert panels (2013: n = 43, 2022: n = 20) were analyzed across core domains: service provision, barriers, financial incentives, and community linkage.

Results

Although the perceived importance of integrated support services remained consistently high (4.79 in 2013, 4.85 in 2022), actual service provision levels remained persistently low, staying below the mid-2.0 range on a five-point scale. While lack of financial support was the primary obstacle in 2013, legal/policy absence and a lack of information-sharing networks emerged as priority barriers in 2022. Experts identified enhancement of legal frameworks (4.65) for community linkage and introduction of specialized treatment fees (4.40) for financial sustainability as priorities.

Conclusions

The paradigm of cancer survivorship care in South Korea has reached a critical juncture, necessitating a shift from infrastructure expansion to functional integration. Addressing this implementation gap requires legal and institutional enhancements to utilize the Survivorship Care Plan effectively as a practical coordinating tool. Ultimately, optimizing institutional roles based on their distinct functions will strengthen the integrated supportive care delivery system.

Key messages

• Diachronic Delphi analysis reveals a persistent implementation gap in survivorship care; despite high perceived importance, service provision remains low due to legal and informational bottlenecks.

• Shifting from infrastructure expansion to functional integration requires institutionalizing legal frameworks and utilizing Survivorship Care Plans to mandate role-sharing and community linkage.