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Higher cost sharing for visiting general hospitals and the changing trend in the first-visited healthcare organization among newly diagnosed hypertension patients

 Jaeyong Shin  ;  Young Choi  ;  Sang Gyu Lee  ;  Tae Hyun Kim  ;  Eun-Cheol Park 
 MEDICINE, Vol.95(40) : 4880, 2016 
Journal Title
Issue Date
Aged ; Comorbidity ; Cost Control ; Cost Sharing/economics* ; Cost Sharing/statistics & numerical data ; Female ; Hospitals, General/economics* ; Hospitals, General/statistics & numerical data ; Humans ; Hypertension/diagnosis* ; Logistic Models ; Male ; Middle Aged ; National Health Programs/economics ; National Health Programs/statistics & numerical data ; Primary Health Care/economics* ; Primary Health Care/statistics & numerical data ; Republic of Korea ; Retrospective Studies ; Socioeconomic Factors
cost ; healthcare delivery system ; hypertension ; Korea ; out-of-pocket money ; sharing
Unnecessary use of high-quality resources in general hospitals hinders treatment of patients with urgent and complicated conditions. Thus, the Korean Government has sought to reduce general hospital visiting of patients with 52 mild diseases, including hypertension. The higher cost sharing for medical expenses and medications from general hospitals were enacted in 2009 and 2011, respectively.We determined whether these regulations were effective through evaluating changing trends in first-visited healthcare organizations and defined the first visiting healthcare organization level (primary clinics, hospital, and general hospital) as an outcome measure.Data of 32,830 mild hypertension patients from 2004 to 2013 were retrieved from the Korean National Health Insurance Service National Sample Cohort. This was a retrospective study involving a large national cohort with patient samples (representing 2% of the total Korean population) stratified on the basis of sociodemographic information.Mutinomial logistic regression were performed for the first visiting to different health organizations, compared to the first visiting to primary clinics.Patients in 2012 and 2013 had significantly lower odds ("2012": 0.68, 95% confidence interval [CI]: 0.56-0.81/"2013": 0.66, 95% CI 0.54-0.81) of first visiting general hospitals compared with those in 2008, although decreased tendencies (albeit nonsignificant) were already evident in 2010 and 2011.Thus, government health policies for cost-containment seem effective in decreasing first visiting of general hospitals among patients with mild essential hypertension. These policies have since extended to Medical Aid beneficiaries; thus, it is needed to continue monitor their results carefully.
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4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Shin, Jae Yong(신재용)
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
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