BACKGROUND: Medical Aid (MA) beneficiaries, belonging to low-income and vulnerable groups, tend to utilize more healthcare services than patients covered by general health insurance. This study aimed to investigate shifts in medical expenses among South Korean MA beneficiaries from 2010 to 2020 in response to changes in health coverage. METHODS: This study was a retrospective cohort study that involved analyzing data from 354,289 MA beneficiaries aged 20 years and older as of 2010 whose healthcare utilization data could be tracked up to 2020. The impact of changes in health coverage of MA beneficiaries on the increase in medical expenses was analyzed with multiple logistic regression analysis. RESULTS: The findings revealed that the group maintaining their MA eligibility had a higher rate of increase in medical expenses compared to those transitioning from MA to National Health Insurance (NHI). Even after adjusting for covariates, the likelihood of an increase in total annual medical expenses was more than 1.4 times higher for the MA maintenance group. However, the group that maintained MA also had higher initial healthcare expenses, indicating poorer health status, compared to the group that transitioned to NHI. CONCLUSION In the public healthcare domain, such as MA, it is crucial to enhance access to necessary healthcare services while preventing unnecessary medical treatments. There is a need for systemic improvements to ensure that low-income, medically vulnerable groups can appropriately use the healthcare services they require to achieve high-value health outcomes.
Republic of Korea ; Humans ; Retrospective Studies ; Middle Aged ; Adult ; Female ; Poverty/statistics & numerical data* ; Male ; Vulnerable Populations/statistics & numerical data* ; Aged ; Health Expenditures/statistics & numerical data* ; Young Adult ; Medical Assistance/statistics & numerical data* ; Insurance Coverage/statistics & numerical data*

Purpose: The purpose of this study was to find out the suicidal ideation rate of the elderly including individual and regional factors by sex. Methods: This is secondary analysis study that combines the data of the 2017 Community Health Survey with the e-indicator data set of the National Statistical Office, and a descriptive correlation study. Statistical analysis used hierarchical logistic regression by SAS 9.4. Results: The 11.5% of the elderly had suicidal ideation within the last year, and 18.4% in Chungnam is the highest. Individual characteristics include females, older people, lower education levels, no job or housewife, no spouse, less than seven hours of sleep per day on the average, low subjective health, high subjective stress, and the worse their economic conditions, the more they had suicide ideation.Considering regional characteristics, suicidal ideation tended to increase significantly as the number of hospital beds per 1,000 people and the rate of obesity was lower, the rate of stress perception was higher, and the odds value was small. When both individual and regional factors were considered, the model conformity of the suicidal ideation improved (ICC=0.0814). Conclusion In order to lower the suicidal rate of the elderly, it seems that both individual and community factors need to be comprehensively approached from the stage of suicidal ideation in the community.