Kim Myunghwa, Kwon Soonman
Health Insurance Review & Assessment Service, Korea.
J Prev Med Public Health. 2010 Nov;43(6):496-504. doi: 10.3961/jpmph.2010.43.6.496.
The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly.
The data in this analysis was the health insurance claims data between July 1999 and December 2008 (114 months). The study group was divided into two age groups, namely 60-64 years old and 65-69 years old. This study evaluated the impact of policy change on office visits, the office visits per person, and the percentage of the copayment-paid visits in total visits. Interrupted time series and segmented regression model were used for statistical analysis.
The results showed that outpatient cost-sharing decreased office visits, but it also decreased the percentage of copayment-paid visits, implying that the intensity of care increased. There was little difference in the results between the two age groups. But after the introduction of the coinsurance system for those patients under age 65, office visits and the percentage of copayment-paid visits decreased, and the 60-64 years old group had a larger decrease than the 65-69 years old group.
This study evaluated the effects of outpatient cost-sharing on health care utilization by the aged. Cost sharing of the elderly had little effect on controlling health care utilization.
本研究旨在分析门诊费用分担对老年人医疗保健利用的影响。
本分析中的数据为1999年7月至2008年12月(114个月)的医疗保险理赔数据。研究组分为两个年龄组,即60 - 64岁和65 - 69岁。本研究评估了政策变化对门诊就诊次数、人均门诊就诊次数以及自付费用就诊次数在总就诊次数中所占百分比的影响。采用中断时间序列和分段回归模型进行统计分析。
结果表明,门诊费用分担减少了门诊就诊次数,但也降低了自付费用就诊次数的百分比,这意味着医疗服务强度增加。两个年龄组的结果差异不大。但在为65岁以下患者引入共保制度后,门诊就诊次数和自付费用就诊次数的百分比均下降,且60 - 64岁组的下降幅度大于65 - 69岁组。
本研究评估了门诊费用分担对老年人医疗保健利用的影响。老年人的费用分担对控制医疗保健利用影响不大。