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Impact of health insurance status changes on healthcare utilisation patterns: a longitudinal cohort study in South Korea

Authors
 Jae-Hyun Kim  ;  Sang Gyu Lee  ;  Kwang-Soo Lee  ;  Sung-In Jang  ;  Kyung-Hee Cho  ;  Eun-Cheol Park 
Citation
 BMJ OPEN, Vol.6(4) : 009538, 2016 
Journal Title
 BMJ OPEN 
Issue Date
2016
MeSH
Adult ; Aged ; Ambulatory Care/trends* ; Female ; Hospitalization/trends* ; Humans ; Insurance Coverage/economics* ; Insurance, Health/economics* ; Longitudinal Studies ; Male ; Middle Aged ; Patient Acceptance of Health Care/statistics & numerical data* ; Republic of Korea ; Young Adult
Keywords
HEALTH ECONOMICS ; HEALTH SERVICES ADMINISTRATION & MANAGEMENT
Abstract
OBJECTIVES: The study examined medical care utilisation by health insurance status changes. SETTING: The Korean Welfare Panel Study (KoWePs) was used. PARTICIPANTS: This study analysed 14,267 participants at baseline (2006). INTERVENTIONS: The individuals were categorised into four health insurance status groups: continuous health insurance, change from health insurance to Medical Aid, change from Medical Aid to health insurance, or continuous Medical Aid. PRIMARY AND SECONDARY OUTCOME MEASURES: Three dependent variables were also analysed: days spent in hospital; number of outpatient visits; and hospitalisations per year. Longitudinal data analysis was used to determine whether changes in health insurance status were associated with healthcare utilisation. RESULTS: The number of outpatient visits per year was 0.1.363 times higher (p<0.0001) in the continuous Medical Aid than in the continuous health insurance group. The number of hospitalisations per year was 1.560 times higher (p<0.001) in new Medical Aid and -0.636 times lower (p<0.001) in new health insurance than in continuous health insurance group. The number of days spent in hospital per year was -0.567 times lower (p=0.021) in the new health insurance than in the continuous health insurance group. CONCLUSIONS: Health insurance beneficiaries with a coverage level lower than Medical Aid showed lower healthcare utilisation, as measured by the number of hospitalisations and days spent in hospital per year.
Files in This Item:
T201601058.pdf Download
DOI
10.1136/bmjopen-2015-009538
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146669
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