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The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul

The Medical Aid program is government’s medical benefit program to secure the minimum livelihood and medical services for low-income Korean households. In Seoul, the number of Medical Aid beneficiaries has grown, driving an increases in the length of stay (LOS) and healthcare cost. Until now, studie...

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Autores principales: Kim, Jungah, Shon, Changwoo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5923814/
https://www.ncbi.nlm.nih.gov/pubmed/29673147
http://dx.doi.org/10.3390/ijerph15040772
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author Kim, Jungah
Shon, Changwoo
author_facet Kim, Jungah
Shon, Changwoo
author_sort Kim, Jungah
collection PubMed
description The Medical Aid program is government’s medical benefit program to secure the minimum livelihood and medical services for low-income Korean households. In Seoul, the number of Medical Aid beneficiaries has grown, driving an increases in the length of stay (LOS) and healthcare cost. Until now, studies have focused on quantity indicators, such as LOS, but only a few studies have been conducted on the service quality. We investigated both LOS and the preventable hospitalization (PH) rate as proxy indicators for the quantity and quality of services provided to Medical Aid beneficiaries in Seoul. To understand the program’s impact, we extracted appropriate data of Medical Aid beneficiaries and data of the lower 20% of National Health Insurance (NHI) enrollees, performed Propensity Score Matching (PSM), and controlled the variables related to disease severity. The differences between Medical Aid beneficiaries and NHI enrollees were estimated using multilevel analysis. The LOS of Medical Aid beneficiaries was longer, and the preventable hospitalization (PH) rate was higher than that of NHI enrollees. It implies that these beneficiaries did not receive timely and adequate healthcare services, despite their high rate of service utilization. Thus, indicators such as patient’s visits and screening related to PHs should be included in management policies to improve primary care.
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spelling pubmed-59238142018-05-03 The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul Kim, Jungah Shon, Changwoo Int J Environ Res Public Health Article The Medical Aid program is government’s medical benefit program to secure the minimum livelihood and medical services for low-income Korean households. In Seoul, the number of Medical Aid beneficiaries has grown, driving an increases in the length of stay (LOS) and healthcare cost. Until now, studies have focused on quantity indicators, such as LOS, but only a few studies have been conducted on the service quality. We investigated both LOS and the preventable hospitalization (PH) rate as proxy indicators for the quantity and quality of services provided to Medical Aid beneficiaries in Seoul. To understand the program’s impact, we extracted appropriate data of Medical Aid beneficiaries and data of the lower 20% of National Health Insurance (NHI) enrollees, performed Propensity Score Matching (PSM), and controlled the variables related to disease severity. The differences between Medical Aid beneficiaries and NHI enrollees were estimated using multilevel analysis. The LOS of Medical Aid beneficiaries was longer, and the preventable hospitalization (PH) rate was higher than that of NHI enrollees. It implies that these beneficiaries did not receive timely and adequate healthcare services, despite their high rate of service utilization. Thus, indicators such as patient’s visits and screening related to PHs should be included in management policies to improve primary care. MDPI 2018-04-17 2018-04 /pmc/articles/PMC5923814/ /pubmed/29673147 http://dx.doi.org/10.3390/ijerph15040772 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Jungah
Shon, Changwoo
The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul
title The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul
title_full The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul
title_fullStr The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul
title_full_unstemmed The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul
title_short The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul
title_sort effects of health coverage schemes on length of stay and preventable hospitalization in seoul
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5923814/
https://www.ncbi.nlm.nih.gov/pubmed/29673147
http://dx.doi.org/10.3390/ijerph15040772
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