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The effect of shifting medical coverage from National Health Insurance to Medical Aid type I and type II on health care utilization and out-of-pocket spending in South Korea

Authors
Lee, DW | Jang, J  | Choi, DW | Jang, SI | Park, EC
Citation
BMC health services research, 20(1). : 979-979, 2020
Journal Title
BMC health services research
ISSN
1472-6963
Abstract
BACKGROUND: This study examines the effects of a shift in medical coverage, from National Health Insurance (NHI) to Medical Aid (MA), on health care utilization (measured by the number of outpatient visits and length of stay; LOS) and out-of-pocket medical expenses.

METHODS: Data were collected from the Korean Welfare Panel Study (2010-2016). A total of 888 MA Type I beneficiaries and 221 MA Type II beneficiaries who shifted from the NHI were included as the case group and 2664 and 663 consecutive NHI holders (1:3 propensity score-matched) were included as the control group, respectively. We used the 'difference-in-differences' (DiD) analysis approach to assess changes in health care utilization and medical spending by the group members.

RESULTS: Differential average changes in outpatient visits in the MA Type I panel between the pre- and post-shift periods were significant, but differential changes in LOS were not found. Those who shifted from NHI to MA Type I had increased number of outpatient visits without changes in out-of-pocket spending, compared to consecutive NHI holder who had similar characteristics. However, this was not found for MA Type II beneficiaries.

CONCLUSION: Our research provides evidence that the shift in medical coverage from NHI to MA Type I increased the number of outpatient visits without increasing the out-of-pocket spending. Considering the problem of excess medical utilization by Korean MA Type I beneficiaries, further researches are required to have in-depth discussions on the appropriateness of the current cost-sharing level on MA beneficiaries.
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DOI
10.1186/s12913-020-05778-2
PMID
33109176
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Preventive Medicine & Public Health
Ajou Authors
장, 지은
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