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*

OBJECTIVES: The purpose of this study was to examine the factors associated with fear of falling among the elderly dwelling in rural communities. METHODS: From February 1, 2010 to March 31, 2010, a questionnaire-based survey was sent to 2,628 persons 65 years or older dwelling in 1 Myeon and 1 Eup of Gyeongsangnam-do. Among these participants, 735 (27.9%) had fallen more than once in 2009. For data analysis, descriptive statistics and hierarchical multiple regression were performed using SPSS version 12.0. RESULTS: Factors influencing the fear of falling in the elderly according to falls experienced were number of outpatient visits, number of falls, gender, admission, purchasing of health function foods, and activities of daily living. Overall, the study showed significant differences in the score of fear of falling according to gender, age, education, marital status, living arrangement, main means of mobilization, drinking, income, number of falls, admission, number of outpatient visits, experience with outpatient oriental medicine, purchasing of health function foods, medical assistance devices, season, fall location, fall cause, shoe type, injury type, limitation of activity, and activities of daily living. CONCLUSIONS: The results of this study suggest that programs should be developed specifically for elderly people who have experienced more than one fall because of increased fear due to multiple falls.
Activities of Daily Living ; Aged ; Drinking ; Humans ; Marital Status ; Medical Assistance ; Medicine, East Asian Traditional ; Outpatients ; Residence Characteristics ; Rural Population ; Seasons ; Shoes ; Statistics as Topic

OBJECTIVES: The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. METHODS: We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. RESULTS: The average continuity of care in the entire population of 1,498,327 patients was 0.89+/-0.17 as calculated by MFPC and 0.92+/-0.16 by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. CONCLUSIONS: The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.
Poverty ; National Health Programs ; Middle Aged ; Medical Assistance ; Male ; Linear Models ; Korea/epidemiology ; Insurance Claim Review ; Humans ; Female ; Diabetes Mellitus/economics/epidemiology/*therapy ; Continuity of Patient Care/economics/*statistics & numerical data ; Aged ; Adult

On 26 December 2004, a huge tsunami struck the coasts of South Asian countries and it resulted in 29,729 deaths and 16,665 injuries in Sri Lanka. This study characterizes the epidemiology, clinical data and time course of the medical problems seen by a Korean disaster medical assistance team (DMAT) during its deployment in Sri Lanka, from 2 to 8 January 2005. The team consisting of 20 surgical and medical personnel began to provide care 7 days after tsunami in the southern part of Sri Lanka, the Matara and Hambantota districts. During this period, a total of 2,807 patients visited our field clinics with 3,186 chief complaints. Using the triage and refer system, we performed 3,231 clinical examinations and made 3,259 diagnoses. The majority of victims had medical problems (82.4%) rather than injuries (17.6%), and most conditions (92.1%) were mild enough to be discharged after simple management. There were also substantial needs of surgical managements even in the second week following the tsunami. Our study also suggests that effective triage system, self-sufficient preparedness, and close collaboration with local authorities may be the critical points for the foreign DMAT activity.
Adolescent ; Adult ; Aged ; Asia, Southeastern ; Child ; Child, Preschool ; Emergency Medical Services/organization & administration/statistics & numerical data ; Female ; Geography ; Humans ; Infant ; Infant, Newborn ; International Cooperation ; Korea ; Male ; *Medical Assistance ; Middle Aged ; *Natural Disasters ; Patients/classification/*statistics & numerical data ; *Relief Work ; Retrospective Studies ; Sri Lanka