Korea Journal of Hospital Management (한국병원경영학회지)

Korean Society of Hospital Management (한국병원경영학회)
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The Impacts of Private Health Insurance on Medical Institution Selection: Evidence from Outpatient Service Utilization among Arthritis Patients

민간의료보험이 의료기관 종별 선택에 미치는 영향: 관절염 환자의 외래 이용을 중심으로

  • You, Chang Hoon (Graduate School of Healthcare Management and Policy, the Catholic University of Korea) ;
  • Kang, Sungwook (Department of Public Health, Daegu Haany University) ;
  • Choi, Ji Heon (International Institute of Health) ;
  • Kwon, Young Dae (Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, the Catholic University of Korea)
  • 유창훈 (가톨릭대학교 의료경영대학원) ;
  • 강성욱 (대구한의대학교 보건학부) ;
  • 최지헌 (지구촌보건의료연구소) ;
  • 권영대 (가톨릭대학교 의과대학 인문사회의학과 및 가톨릭의료경영연구소)
  • Received : 2017.02.15
  • Accepted : 2017.04.14
  • Published : 2017.06.30
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Abstract

Recently, with the increase in the number of private health insurance subscribers, interest in overuse of the medical service is increasing. This study analyzed the impacts of private health insurance (PHI) on medical institution selection in outpatient service utilization among persons with arthritis. In order to control patients' health status, we extracted outpatient episodes with the same disease (KCD6, M13) from Korea Health Panel. The unit of analysis was an outpatient visit with arthritis in 2014 (n=23,363). In the light of insurance coverage, we redefined three type of private health insurance (ex, indemnity, fixed benefit, and non-insured) as a test variable and two type of medical institution (ex, hospital and physician visit) as a dependent variable. We conducted a probit regression analysis to identify the impacts of PHI on medical institution selection controlling for heteroscedasticity. The results of this study showed that the insured with indemnity were more likely to choose hospital departments than clinics (marginal effect=0.0475, p=0.000). The impact of participation of fixed benefit PHI was not as clear as that of indemnity type (marginal effect=0.0162, p=0.047). In conclusion, this study confirmed that PHI, particularly indemnity type has a significant impact on the selection of medical institutions. Healthcare policy makers should consider that PHI not only affects the overall quantitative increase in healthcare utilization, but also influences the selection of medical institutions.

Keywords

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