Cargando…

Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea

This study aimed to investigate pediatric health access by describing the ecology of medical care for children and adolescents in a medical environment where a well-balanced system between national health insurance (NHI) and private medical insurance (PMI) is required. Data from 2746 individuals age...

Descripción completa

Detalles Bibliográficos
Autores principales: Ryu, Dong-Hee, Choi, Yong-jun, Lee, Jeehye
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330897/
https://www.ncbi.nlm.nih.gov/pubmed/35892604
http://dx.doi.org/10.3390/children9081101
_version_ 1784758273270874112
author Ryu, Dong-Hee
Choi, Yong-jun
Lee, Jeehye
author_facet Ryu, Dong-Hee
Choi, Yong-jun
Lee, Jeehye
author_sort Ryu, Dong-Hee
collection PubMed
description This study aimed to investigate pediatric health access by describing the ecology of medical care for children and adolescents in a medical environment where a well-balanced system between national health insurance (NHI) and private medical insurance (PMI) is required. Data from 2746 individuals aged 18 years old and younger were used. Of the participants, 87.3% had private medical insurance. Of the 1000 children, in an average month, 404 visited a clinic, 67 visited a hospital outpatient department (OPD), 49 visited an OPD in a tertiary hospital, 11 received emergency care, 5 received inpatient care in a hospital, and 9 were hospitalized. The generalized estimating equation models adjusted for age, sex, economic status, and pediatric comorbidity index were used for multivariate analysis. Receiving ambulatory care services in clinics was significantly more likely among children and adolescents with private medical insurance (adjusted odds ratio [aOR] = 1.16 [95% confidence interval [CI]: 1.00–1.35]). Receiving ambulatory care services in clinics was significantly more likely among indemnity type policyholders (aOR = 1.23 [1.05–1.45]) and single policyholders (aOR = 1.18 [1.00–1.37]). Countries with national health insurance schemes should continuously practice the proper regulation and management of PMI, including reviewing PMI compensation measures, NHI reimbursement standards, and consumers’ perspectives on NHI and PMI.
format Online
Article
Text
id pubmed-9330897
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-93308972022-07-29 Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea Ryu, Dong-Hee Choi, Yong-jun Lee, Jeehye Children (Basel) Article This study aimed to investigate pediatric health access by describing the ecology of medical care for children and adolescents in a medical environment where a well-balanced system between national health insurance (NHI) and private medical insurance (PMI) is required. Data from 2746 individuals aged 18 years old and younger were used. Of the participants, 87.3% had private medical insurance. Of the 1000 children, in an average month, 404 visited a clinic, 67 visited a hospital outpatient department (OPD), 49 visited an OPD in a tertiary hospital, 11 received emergency care, 5 received inpatient care in a hospital, and 9 were hospitalized. The generalized estimating equation models adjusted for age, sex, economic status, and pediatric comorbidity index were used for multivariate analysis. Receiving ambulatory care services in clinics was significantly more likely among children and adolescents with private medical insurance (adjusted odds ratio [aOR] = 1.16 [95% confidence interval [CI]: 1.00–1.35]). Receiving ambulatory care services in clinics was significantly more likely among indemnity type policyholders (aOR = 1.23 [1.05–1.45]) and single policyholders (aOR = 1.18 [1.00–1.37]). Countries with national health insurance schemes should continuously practice the proper regulation and management of PMI, including reviewing PMI compensation measures, NHI reimbursement standards, and consumers’ perspectives on NHI and PMI. MDPI 2022-07-22 /pmc/articles/PMC9330897/ /pubmed/35892604 http://dx.doi.org/10.3390/children9081101 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ryu, Dong-Hee
Choi, Yong-jun
Lee, Jeehye
Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
title Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
title_full Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
title_fullStr Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
title_full_unstemmed Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
title_short Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
title_sort pediatric health access and private medical insurance: based on the ecology of medical care in korea
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330897/
https://www.ncbi.nlm.nih.gov/pubmed/35892604
http://dx.doi.org/10.3390/children9081101
work_keys_str_mv AT ryudonghee pediatrichealthaccessandprivatemedicalinsurancebasedontheecologyofmedicalcareinkorea
AT choiyongjun pediatrichealthaccessandprivatemedicalinsurancebasedontheecologyofmedicalcareinkorea
AT leejeehye pediatrichealthaccessandprivatemedicalinsurancebasedontheecologyofmedicalcareinkorea