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상복부초음파검사 급여확대에 따른 의료이용의 변화: 이중차이 혼합효과모형 추정방법을 이용하여

Other Titles
 Effect of Coverage Expansion Policy for an Ultrasonography in the Upper Abdomen on Its Utilization: A Difference-in-Difference Mixed-Effects Model Analysis 
Authors
 손예나  ;  이용재  ;  남정모  ;  김규리  ;  정우진 
Citation
 Health Policy and Management (보건행정학회지), Vol.30(3) : 326-334, 2020-09 
Journal Title
 Health Policy and Management (보건행정학회지) 
Issue Date
2020-09
Keywords
Health insurance coverage expansion ; Upper abdomen ; Uultrasonography ; Difference-in-difference ; Mixed model ; Republic of Korea
Abstract
Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.
Files in This Item:
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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
Kim, Gyu Ri(김규리) ORCID logo https://orcid.org/0000-0003-3624-3971
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Chung, Woo Jin(정우진) ORCID logo https://orcid.org/0000-0003-2090-4851
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180534
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