This paper tested by using Micro TSP, an empirical econometric analysis to approve officially a hypothesis of price elasticity of the demand for medical care services in Korean national medical insurance and the economic effect of health care delivery system with time-series datas of Medical Insurance statistical yearbook(1981-1993). The results suggest that the korean medical insurance system shows moral hazard due to the change of coinsurance and the economic effect according to intervention of the health care delivery system, but it is different by insurers regardless of the same structure of the medical insurance scheme.
Deductibles and Coinsurance ; Delivery of Health Care ; Elasticity* ; Insurance ; Insurance Carriers ; National Health Programs*

The Korean government implemented a new policy on October 1st, 2011, requiring that patients with type 2 diabetes in the general or university hospital system pay 40% or 50% rather than 30% of total prescription drug costs. The Diabetes Association of Korea performed a survey regarding satisfaction with the new policy among patients with diabetes from August 24th to September 2nd, 2011. A total of 548 patients participated in the survey through one-to-one interviews. About 90% of patients with diabetes regarded diabetes as a serious disease, while only 4.5% regarded diabetes as a mild disease. The reasons why patients regarded diabetes as a serious disease were risks of developing diabetic complications (64.3%), difficulty of diabetes care (18.0%), and difficulty of cure (15.1%). About 70% of patients felt burdened by the increased prescription drug costs and deductibles, while only 12% did not. Finally, 85% of patients thought that the new policy was unfair to patients with diabetes and about 75% of patients regarded the new policy as inappropriate. In conclusion, the Korean government's new high deductible policy for patients with diabetes in the general/university hospital system should be withdrawn immediately.
Deductibles and Coinsurance ; Diabetes Complications ; Diabetes Mellitus ; Drug Costs ; Humans ; Insurance, Health, Reimbursement ; Korea ; Prescriptions

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.
Ambulatory Care ; Cohort Studies ; Deductibles and Coinsurance* ; Delivery of Health Care ; Hospitals, General ; Humans ; Logistic Models ; Mentally Ill Persons ; National Health Programs ; Outpatients* ; Prescriptions