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Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries

OBJECTIVES: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. METHODS: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19...

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Autores principales: Kim, Un-Na, Kim, Yeon-Yong, Lee, Jin-Seok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society for Preventive Medicine 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750509/
https://www.ncbi.nlm.nih.gov/pubmed/26841885
http://dx.doi.org/10.3961/jpmph.15.052
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author Kim, Un-Na
Kim, Yeon-Yong
Lee, Jin-Seok
author_facet Kim, Un-Na
Kim, Yeon-Yong
Lee, Jin-Seok
author_sort Kim, Un-Na
collection PubMed
description OBJECTIVES: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. METHODS: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. RESULTS: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. CONCLUSIONS: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.
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spelling pubmed-47505092016-02-23 Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries Kim, Un-Na Kim, Yeon-Yong Lee, Jin-Seok J Prev Med Public Health Original Article OBJECTIVES: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. METHODS: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. RESULTS: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. CONCLUSIONS: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients. Korean Society for Preventive Medicine 2016-01 2015-12-22 /pmc/articles/PMC4750509/ /pubmed/26841885 http://dx.doi.org/10.3961/jpmph.15.052 Text en Copyright © 2016 The Korean Society for Preventive Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Un-Na
Kim, Yeon-Yong
Lee, Jin-Seok
Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries
title Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries
title_full Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries
title_fullStr Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries
title_full_unstemmed Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries
title_short Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries
title_sort factors affecting the downward mobility of psychiatric patients: a korean study of national health insurance beneficiaries
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750509/
https://www.ncbi.nlm.nih.gov/pubmed/26841885
http://dx.doi.org/10.3961/jpmph.15.052
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