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Copayment policy effects on healthcare spending and utilization by korean lung cancer patients at end of life: a retrospective cohort design 2003-2012.

Authors
 Sun Jung Kim  ;  Kyu-Tae Han  ;  Eun-Cheol Park  ;  Sohee Park  ;  Tae Hyun Kim 
Citation
 ASIAN PACIFIC JOURNAL OF CANCER PREVENTION, Vol.15(13) : 5265-5270, 2014 
Journal Title
 ASIAN PACIFIC JOURNAL OF CANCER PREVENTION 
ISSN
 1513-7368 
Issue Date
2014
MeSH
Aged ; Costs and Cost Analysis/economics ; Female ; Health Expenditures ; Health Policy/economics* ; Hospitalization/economics ; Humans ; Inpatients ; Insurance, Health/economics* ; Lung Neoplasms/economics* ; Male ; National Health Programs/economics* ; Outpatients ; Patient Acceptance of Health Care ; Republic of Korea ; Retrospective Studies
Keywords
Lung cancer ; copayment policy ; length of stay ; costs-sharing ; healthcare spending
Abstract
Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.
Files in This Item:
T201402279.pdf Download
DOI
10.7314/APJCP.2014.15.13.5265
Appears in Collections:
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, So Hee(박소희) ORCID logo https://orcid.org/0000-0001-8513-5163
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99238
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