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首页> 外文期刊>BMC Health Services Research >The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: a study of the Korean health panel survey (2008–2012)
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The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: a study of the Korean health panel survey (2008–2012)

机译：私人健康保险中费用分摊对私人保险购买者与非购买者之间利用医疗保健服务的影响：韩国医疗小组调查研究（2008-2012年）

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Background Private health insurance in South Korea mainly functions as supplementary and complementary health insurance that compensates for insufficient coverage by National Health Insurance. However, full private coverage of public sector cost-sharing led to the problem of encouraging moral hazard–induced utilization, resulting in a policy change that occurred in October 2009. At that time, the Korean government introduced a minimum cost-sharing policy for indemnity health insurance. The purpose of this study was to analyze the effect of cost-sharing in private health insurance on health care utilization. Methods We analyzed data collected from the Korean Health Panel Survey from October 2008 to December 2011. We restricted the two groups to 803 purchasers with indemnity health insurance and 7023 non-purchasers who did not obtain any private health insurance. A difference-in-difference analysis was used to evaluate the effect of the 2009 policy. Results After the policy change, the utilization of outpatient visits by purchasers gradually decreased more than non-purchasers (0.015 in 2009 [p?=?0.758], ?0.117 in 2010 [p?p?=?0.004]). However, utilization of inpatient services was not statistically significant. Notably, the magnitude of the cost-sharing effect in indemnity health insurance was stronger for those receiving medical aid. Among this group, utilization of outpatient services (after the policy change in 2009) decreased more so than non-purchasers. Patients with three or more chronic diseases have not changed their health care utilization. Conclusions Our results implied meaningful lessons for decision-makers and future health insurance policies in Korea and other countries in terms of cost-sharing in medical care. When policy makers intend to implement the cost-sharing, a different copayment scheme is needed according to the socioeconomic status or disease severity.
机译：背景技术韩国的私人健康保险主要用作补充和补充健康保险，以弥补国民健康保险的不足。但是，私人部门对公共部门成本分摊的全面覆盖导致了鼓励道德风险引起的利用的问题，导致2009年10月发生了政策变化。当时，韩国政府出台了最低赔款分担政策。健康保险。本研究的目的是分析私人医疗保险中的费用分摊对医疗保健利用的影响。方法我们分析了从2008年10月至2011年12月韩国健康小组调查收集的数据。我们将这两组人限制为803名购买了弥偿性健康保险的购买者和7023名未获得任何私人健康保险的非购买者。差异分析用于评估2009年政策的效果。结果政策改变后，购买者的门诊使用率逐渐比非购买者下降更多（2009年为0.015 [p？= 0.758]，2010年为0.117 [p？p？= 0.004]）。但是，住院服务的利用在统计上并不显着。值得注意的是，对于接受医疗救助的人来说，弥偿性医疗保险中分担费用的效果更大。在这些人群中，门诊服务的利用率（在2009年政策改变后）比非购买者的下降幅度更大。患有三种或三种以上慢性病的患者没有改变他们的医疗保健利用率。结论我们的结果为韩国和其他国家的决策者和未来的健康保险政策提供了有意义的教训，涉及医疗费用分担。当政策制定者打算实施成本分摊时，需要根据社会经济状况或疾病严重程度制定不同的共付额方案。

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