Cargando…

The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching

STUDY OBJECTIVES: Health care utilization has progressively increased, especially among Medical Aid beneficiaries in South Korea. The Medical Aid classifies beneficiaries into two categories, type 1 and 2, on the basis of being incapable (those under 18 or over 65 years of age, or disabled) or capab...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Jae-Hyun, Lee, Kwang-Soo, Yoo, Ki-Bong, Park, Eun-Cheol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376904/
https://www.ncbi.nlm.nih.gov/pubmed/25816234
http://dx.doi.org/10.1371/journal.pone.0119939
_version_ 1782363808500547584
author Kim, Jae-Hyun
Lee, Kwang-Soo
Yoo, Ki-Bong
Park, Eun-Cheol
author_facet Kim, Jae-Hyun
Lee, Kwang-Soo
Yoo, Ki-Bong
Park, Eun-Cheol
author_sort Kim, Jae-Hyun
collection PubMed
description STUDY OBJECTIVES: Health care utilization has progressively increased, especially among Medical Aid beneficiaries in South Korea. The Medical Aid classifies beneficiaries into two categories, type 1 and 2, on the basis of being incapable (those under 18 or over 65 years of age, or disabled) or capable of working, respectively. Medical Aid has a high possibility for health care utilization due to high coverage level. In South Korea, the national health insurance (NHI) achieved very short time to establish coverage for the entire Korean population. However there there remaine a number of problems to be solved. Therefore, the objective of this study was to investigate the differences in health care utilization between Medical Aid beneficiaries and Health Insurance beneficiaries. METHODS & DESIGN: Data were collected from the Korean Welfare Panel Study from 2008 to 2012 using propensity score matching. Of the 2,316 research subjects, 579 had Medical Aid and 1,737 had health insurance. We also analyzed three dependent variables: days spent in the hospital, number of outpatient visits, and hospitalizations per year. Analysis of variance and longitudinal data analysis were used. RESULTS: The number of outpatient visits was 1.431 times higher (p<0.0001) in Medical Aid beneficiaries, the number of hospitalizations per year was 1.604 times higher (p<0.0001) in Medical Aid beneficiaries, and the number of days spent in the hospital per year was 1.282 times higher (p<0.268) for Medical Aid beneficiaries than in individuals with Health Insurance. Medical Aid patients had a 0.874 times lower frequency of having an unmet needs due to economic barrier (95% confidence interval: 0.662-1.156). CONCLUSIONS: Health insurance coverage has an impact on health care utilization. More health care utilization among Medical Aid beneficiaries appears to have a high possibility of a moral hazard risk under the Health Insurance program. Therefore, the moral hazard for Medical Aid beneficiaries should be avoided.
format Online
Article
Text
id pubmed-4376904
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-43769042015-04-04 The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching Kim, Jae-Hyun Lee, Kwang-Soo Yoo, Ki-Bong Park, Eun-Cheol PLoS One Research Article STUDY OBJECTIVES: Health care utilization has progressively increased, especially among Medical Aid beneficiaries in South Korea. The Medical Aid classifies beneficiaries into two categories, type 1 and 2, on the basis of being incapable (those under 18 or over 65 years of age, or disabled) or capable of working, respectively. Medical Aid has a high possibility for health care utilization due to high coverage level. In South Korea, the national health insurance (NHI) achieved very short time to establish coverage for the entire Korean population. However there there remaine a number of problems to be solved. Therefore, the objective of this study was to investigate the differences in health care utilization between Medical Aid beneficiaries and Health Insurance beneficiaries. METHODS & DESIGN: Data were collected from the Korean Welfare Panel Study from 2008 to 2012 using propensity score matching. Of the 2,316 research subjects, 579 had Medical Aid and 1,737 had health insurance. We also analyzed three dependent variables: days spent in the hospital, number of outpatient visits, and hospitalizations per year. Analysis of variance and longitudinal data analysis were used. RESULTS: The number of outpatient visits was 1.431 times higher (p<0.0001) in Medical Aid beneficiaries, the number of hospitalizations per year was 1.604 times higher (p<0.0001) in Medical Aid beneficiaries, and the number of days spent in the hospital per year was 1.282 times higher (p<0.268) for Medical Aid beneficiaries than in individuals with Health Insurance. Medical Aid patients had a 0.874 times lower frequency of having an unmet needs due to economic barrier (95% confidence interval: 0.662-1.156). CONCLUSIONS: Health insurance coverage has an impact on health care utilization. More health care utilization among Medical Aid beneficiaries appears to have a high possibility of a moral hazard risk under the Health Insurance program. Therefore, the moral hazard for Medical Aid beneficiaries should be avoided. Public Library of Science 2015-03-27 /pmc/articles/PMC4376904/ /pubmed/25816234 http://dx.doi.org/10.1371/journal.pone.0119939 Text en © 2015 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Kim, Jae-Hyun
Lee, Kwang-Soo
Yoo, Ki-Bong
Park, Eun-Cheol
The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching
title The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching
title_full The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching
title_fullStr The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching
title_full_unstemmed The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching
title_short The Differences in Health Care Utilization between Medical Aid and Health Insurance: A Longitudinal Study Using Propensity Score Matching
title_sort differences in health care utilization between medical aid and health insurance: a longitudinal study using propensity score matching
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376904/
https://www.ncbi.nlm.nih.gov/pubmed/25816234
http://dx.doi.org/10.1371/journal.pone.0119939
work_keys_str_mv AT kimjaehyun thedifferencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching
AT leekwangsoo thedifferencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching
AT yookibong thedifferencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching
AT parkeuncheol thedifferencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching
AT kimjaehyun differencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching
AT leekwangsoo differencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching
AT yookibong differencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching
AT parkeuncheol differencesinhealthcareutilizationbetweenmedicalaidandhealthinsurancealongitudinalstudyusingpropensityscorematching