An Analysis of Effects of Differential Coinsurance Policy and Utilization of Outpatients Care by Types of Medical Institutions.
10.4332/KJHPA.2017.27.2.128
- Author:
Yoon Sung PARK
1
;
Jin Suk KIM
Author Information
1. Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea. philiakjs@gmail.com
- Publication Type:Original Article
- Keywords:
Outpatients;
52 ambulatory care sensitive conditions;
Differential coinsurance policy;
Prescription drug coverage;
Health care delivery system
- MeSH:
Ambulatory Care;
Cohort Studies;
Deductibles and Coinsurance*;
Delivery of Health Care;
Hospitals, General;
Humans;
Logistic Models;
Mentally Ill Persons;
National Health Programs;
Outpatients*;
Prescriptions
- From:Health Policy and Management
2017;27(2):128-138
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. METHODS: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. RESULTS: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. CONCLUSION: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.
