Ki-Bong Yoo1, Hong-Uk Ahn2, Eun-Cheol Park3, Tae Hyun Kim4, Sun Jung Kim5, Jeoung A Kwon6, Sang Gyu Lee7. 1. Department of Healthcare Management, Eulji University, Republic of Korea. Electronic address: kb53545@gmail.com. 2. National Health Insurance Service, Republic of Korea. Electronic address: hongahn@nhis.or.kr. 3. Institute of Health Services Research, Yonsei University, Republic of Korea; Department of Preventive Medicine, College of Medicine Yonsei University, Republic of Korea. Electronic address: ecpark@yuhs.ac. 4. Institute of Health Services Research, Yonsei University, Republic of Korea; Graduate School of Public Health, Yonsei University, Republic of Korea. Electronic address: thkim@yuhs.ac. 5. Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Republic of Korea. Electronic address: sunjkim0623@gmail.com. 6. Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Republic of Korea. Electronic address: kwon.jeounga@gmail.com. 7. Institute of Health Services Research, Yonsei University, Republic of Korea; Graduate School of Public Health, Yonsei University, Republic of Korea. Electronic address: leevan@yuhs.ac.
Abstract
BACKGROUND: The Korean government implemented an outpatient co-payment scheme in July 2007 to control Medical-Aid beneficiaries' overutilization of healthcare services. OBJECTIVES: To assess changes in the utilization of medical services resulting from the outpatient co-payment scheme. METHODS: 410,142 subjects were selected and health insurance reimbursement data from July 2006 to June 2011 was examined. We assessed the changes in the total medical cost, total adjusted patient days, inpatient days, inpatient total medical cost, the number of outpatient visits, and outpatient total medical cost using segmented regression analysis. RESULTS: Following the introduction of the policy, the number of outpatient visits per person fell by 0.16 days in July 2008, and by 0.06 days in July 2010, compared to June 2007. The outpatient total medical cost per person rose by $4.11 in July 2010 compared to June 2007. The inpatient utilization increased constantly during the period of the study. So the total medical cost as well as the total adjusted number of patient days also increased constantly. CONCLUSION: The outpatient co-payment policy was effective for reducing the number of outpatient visits. It could not control the cost per outpatient visit and inpatient utilization. So the total medical cost was increased.
BACKGROUND: The Korean government implemented an outpatient co-payment scheme in July 2007 to control Medical-Aid beneficiaries' overutilization of healthcare services. OBJECTIVES: To assess changes in the utilization of medical services resulting from the outpatient co-payment scheme. METHODS: 410,142 subjects were selected and health insurance reimbursement data from July 2006 to June 2011 was examined. We assessed the changes in the total medical cost, total adjusted patient days, inpatient days, inpatient total medical cost, the number of outpatient visits, and outpatient total medical cost using segmented regression analysis. RESULTS: Following the introduction of the policy, the number of outpatient visits per person fell by 0.16 days in July 2008, and by 0.06 days in July 2010, compared to June 2007. The outpatient total medical cost per person rose by $4.11 in July 2010 compared to June 2007. The inpatient utilization increased constantly during the period of the study. So the total medical cost as well as the total adjusted number of patient days also increased constantly. CONCLUSION: The outpatient co-payment policy was effective for reducing the number of outpatient visits. It could not control the cost per outpatient visit and inpatient utilization. So the total medical cost was increased.