Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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The Impact of Outpatient Coinsurance Rate Increase on Outpatient Healthcare Service Utilization in Tertiary and General Hospital

외래 본인부담률 인상이 상급종합병원과 종합병원 외래 의료이용에 미친 영향

  • Kim, Hyo-Jeong (Department of Healthcare Management, Graduate School of Eulji University) ;
  • Kim, Young-Hoon (Department of Healthcare Management, Graduate School of Eulji University) ;
  • Kim, Han-Sung (Department of Healthcare Management, Graduate School of Eulji University) ;
  • Woo, Jung-Sik (Department of Healthcare Management, Graduate School of Eulji University) ;
  • Oh, Su-Jin (Department of Healthcare Management, Graduate School of Eulji University)
  • 김효정 (을지대학교 대학원 의료경영학과) ;
  • 김영훈 (을지대학교 대학원 의료경영학과) ;
  • 김한성 (을지대학교 대학원 의료경영학과) ;
  • 우정식 (을지대학교 대학원 의료경영학과) ;
  • 오수진 (을지대학교 대학원 의료경영학과)
  • Received : 2013.01.23
  • Accepted : 2013.03.04
  • Published : 2013.03.31
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Abstract

Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

Keywords

References

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