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首页> 外文学位 >Effect of patient cost sharing in South Korea: ACG risk-adjusted differences in health care utilization and expenditures among national health insurance and medical aid enrollees, 2004--2005.
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Effect of patient cost sharing in South Korea: ACG risk-adjusted differences in health care utilization and expenditures among national health insurance and medical aid enrollees, 2004--2005.

机译：韩国患者费用分摊的影响：2004--2005年ACG风险调整后的国家健康保险和医疗救助参与者之间在医疗利用和支出方面的差异。

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摘要

Objectives. To determine whether the insurance status of an enrollee is related to the enrollee's probability of utilization and expenditures; the enrollee's choice of health care provider as the most frequent source of care; and the enrollee's hospitalizations for ambulatory care sensitive conditions (ACSCs), after controlling for potential confounders.;Methods. South Korean claims data from 2004 and 2005 were analyzed. Analyses control for demographic and case-mix risk factors of the study population. Common two-part econometric estimation techniques are used to test the relationship between insurance status and expenditures. A logit regression was used to examine whether the insurance status of patients is associated with the likelihood of having a hospital outpatient department (HOPD) as their most frequent source of care (MFSC). A multinomial logit was used to examine the relative risk of varying MFSC for individuals in different insurance programs. Finally, a logit regression was used to compare the likelihood of ambulatory care sensitive admissions (ACSAs) among patients using HOPDs as their MFSC for outpatient services with other patients receiving outpatient services from non-HOPDs.;Results. Compared to low-income National Health Insurance (NHI) enrollees, Medical Aid II (MA2) groups were not experiencing higher expenditures, while Medical Aid I (MA1) groups were experiencing higher expenditures. After adjustment, differences in expenditures by insurance status were diminished. Compared to the NHI counterparts, MA1 beneficiaries were more likely to use an HOPD as the MFSC, while MA2 beneficiaries were less likely to. MA1 and MA2 recipients who used an HOPD as their MFSC were more likely to be admitted for ACSCs than those who did not. Among those who used an HOPD as the MFSC, it was found that MA beneficiaries were more likely to have an ACSA.;Conclusions. Increased cost sharing to MA2 recipients would be expected to lead to less utilization and potentially negative effects on their health. Imposing cost sharing on MA1 groups would be a policy alternative for containing utilization and expenditures. Guiding MA patients to use sources of care other than HOPDs for ambulatory care services may lead to fewer ACSA.
机译：目标。确定参与者的保险状态是否与参与者的使用和支出概率有关；参选人选择的医疗服务提供者为最常见的医疗来源；在控制了潜在的混杂因素之后，以及对入院者住院的非卧床护理敏感病情（ACSC）。分析了2004年和2005年韩国的索赔数据。分析对研究人群的人口统计学和病例混合风险因素的控制。常用的两部分计量经济学估计技术用于测试保险状况与支出之间的关系。 Logit回归用于检查患者的保险状况是否与将医院门诊部门（HOPD）用作其最常见的护理来源（MFSC）的可能性相关。多项式logit用于检查不同保险计划中的个人MFSC变化的相对风险。最后，使用logit回归比较使用HOPD作为门诊服务的MFSC的患者与接受非HOPD门诊服务的其他患者进行门诊医疗敏感入院（ACSA）的可能性。与低收入国民健康保险（NHI）参加者相比，医疗援助II（MA2）组的支出没有增加，而医疗援助I（MA1）组的支出却增加了。调整后，按保险状况分列的支出差异有所减少。与NHI同行相比，MA1受益人更有可能使用HOPD作为MFSC，而MA2受益人则不太可能。使用HOPD作为MFSC的MA1和MA2接收者比没有使用HOPD的MA1和MA2接收者更有可能被接纳为ACSC。在那些将HOPD用作MFSC的人中，发现MA的受益人更有可能获得ACSA。与MA2接收者的费用分担增加将导致使用率降低，并可能对其健康造成负面影响。对MA1组实施成本分摊将是控制利用率和支出的另一种政策选择。指导MA患者使用HOPD以外的其他护理来源进行门诊服务可能会减少ACSA。

著录项

  • 作者

    Kim, Seung Ouk.;

  • 作者单位

    The Johns Hopkins University.;

  • 授予单位 The Johns Hopkins University.;
  • 学科 Health Sciences Public Health.;Health Sciences Health Care Management.
  • 学位 Ph.D.
  • 年度 2009
  • 页码 256 p.
  • 总页数 256
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;预防医学、卫生学;
  • 关键词

  • 入库时间 2022-08-17 11:38:24

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