Factors affecting utilisation of traditional Korean medical services by privately insured persons: a retrospective study using Korean Health Panel Survey (KHPS)

OBJECTIVE: This study aimed to use the Korean Health Panel Survey (KHPS) data to identify the key factors that influence decisions regarding the use of traditional Korean medicine (TKM) by privately insured persons. DESIGN: A retrospective study on episodic KHPS data from 2009 to 2013. SETTING: Nationwide-based survey using the KHPS data. PARTICIPANTS: The study included outpatients aged ≥20 years who had used private medical insurance at least once during the 5 years of the survey. After excluding cases where TKM was not used and those with missing values, this study ultimately included 1874 patients. PRIMARY AND SECONDARY OUTCOME MEASURES: The main dependent variable was TKM utilisation (number of outpatient visits and outpatient costs of TKM). We used multiple linear regression analysis to identify determinants of TKM while controlling for clustered errors. RESULTS: Approximately 6.1% (1874) of all doctor visits (30 982) were characterised as TKM services. For therapeutic purposes, TKM visits increased despite not being guaranteed in private health insurance (coefficient=3.0, p=0.045) and TKM outpatient costs decreased (coefficient=−0.3, p=0.001). Women used more therapeutic TKM services than men (coefficient=2.8, p<0.001). Older patient groups used more therapeutic TKM services than younger patient groups (coefficient=11.5, p=0.012), but paid less on outpatient costs than younger groups (coefficient=−1.0, p=0.001). For preventive services, sex and age were not statistically significant factors. Regardless of the purpose of the visit, the more chronic diseases, the more people who have previously experienced TKM service use more TKM services (p<0.001). CONCLUSIONS: Despite a policy to reduce services that are not guaranteed by private health insurance, the increase in the number of outpatient visits for uncovered therapeutic TKM services implies a high public need for TKM in Korea.