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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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 |
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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 |
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