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Impact of a diagnosis-related group payment system on cesarean section in Korea.

DC FieldValueLanguage
dc.contributor.author박은철-
dc.date.accessioned2017-02-27T07:49:56Z-
dc.date.available2017-02-27T07:49:56Z-
dc.date.issued2016-
dc.identifier.issn0168-8510-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/147004-
dc.description.abstractCesarean sections (CSs) are the most expensive method of delivery, which may affect the physician's choice of treatment when providing health services to patients. We investigated the effects of the diagnosis-related group (DRG)-based payment system on CSs in Korea. We used National Health Insurance claim data from 2011 to 2014, which included 1,289,989 delivery cases at 674 hospitals. We used a generalized estimating equation model to evaluate the association between the likelihood of cesarean delivery and the length of the DRG adoption period. A total of 477,309 (37.0%) delivery cases were performed by CSs. We found that a longer DRG adoption period was associated with a lower odds ratio of CSs (odds ratio [OR]: 0.997, 95% CI: 0.996-0.998). In addition, a longer DRG adoption period was associated with a lower odds ratio for CSs in hospitals that had voluntarily adopted the DRG system. Similar results were also observed for urban hospitals, primiparas, and those under 28 years old and over 33 years old. Our results suggest that the change in the reimbursement system was associated with a low likelihood of CSs. The impact of DRG adoption on cesarean delivery can also be expected to increase with time, as our finding provides evidence that the reimbursement system is associated with the health provider's decision to provide health services for patients.-
dc.description.statementOfResponsibilityrestriction-
dc.format.extent596~603-
dc.languageEnglish-
dc.publisherElsevier Scientific Publishers-
dc.relation.isPartOfHEALTH POLICY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHCesarean Section/utilization*-
dc.subject.MESHDiagnosis-Related Groups/economics*-
dc.subject.MESHFemale-
dc.subject.MESHHealth Expenditures/trends*-
dc.subject.MESHHospitals, Urban/statistics & numerical data-
dc.subject.MESHHumans-
dc.subject.MESHInsurance Claim Review-
dc.subject.MESHModels, Statistical-
dc.subject.MESHPregnancy-
dc.subject.MESHRepublic of Korea-
dc.titleImpact of a diagnosis-related group payment system on cesarean section in Korea.-
dc.typeArticle-
dc.publisher.locationIreland-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Preventive Medicine-
dc.contributor.googleauthorSeung Ju Kim-
dc.contributor.googleauthorKyu-Tae Han-
dc.contributor.googleauthorSun Jung Kim-
dc.contributor.googleauthorEun-Cheol Park-
dc.contributor.googleauthorHye Ki Park-
dc.identifier.doi10.1016/j.healthpol.2016.04.018-
dc.contributor.localIdA01618-
dc.relation.journalcodeJ00971-
dc.identifier.eissn1872-6054-
dc.identifier.pmid27173768-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0168851016301117-
dc.subject.keywordCesarean delivery-
dc.subject.keywordDiagnosis related groups-
dc.subject.keywordPayment reform-
dc.contributor.alternativeNamePark, Eun Chul-
dc.contributor.affiliatedAuthorPark, Eun Chul-
dc.citation.volume120-
dc.citation.number6-
dc.citation.startPage596-
dc.citation.endPage603-
dc.identifier.bibliographicCitationHEALTH POLICY, Vol.120(6) : 596-603, 2016-
dc.date.modified2017-02-24-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers

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