School of Public Health, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, South Korea.
Health Policy. 2013 Nov;113(1-2):69-76. doi: 10.1016/j.healthpol.2013.05.007. Epub 2013 Jun 17.
This study examined the effect of private health insurance (PHI) on health care utilization in South Korea using a nationally representative sample of 9512 adults participating in Korea Health Panel Survey (KHPS). We compared the health care utilization and subsequent expenditure according to whether or not and how many PHIs are purchased, controlling for the endogeneity of insurance purchase by propensity score matching method and Heckman-type treatment effect model. The results of this study show that the probability of any health care utilization, both outpatient care and inpatient care, is higher for the people who have PHI. For those who utilize health care, PHI has a positive impact on outpatient expenditure, but not on the number of outpatient visits. The effect of PHI on the number of inpatient days and expenditure is not statistically significant among the users of inpatient care. These results imply a need for policy options to mitigate the moral hazard effect of PHI in the outpatient care sector.
本研究使用参与韩国健康面板调查（KHPS）的 9512 名成年人的全国代表性样本，考察了私人健康保险（PHI）对韩国医疗保健利用的影响。我们通过倾向得分匹配法和 Heckman 型处理效应模型控制了保险购买的内生性，比较了购买和未购买以及购买多少 PHI 的人群的医疗保健利用情况和随后的支出。本研究结果表明，拥有 PHI 的人进行任何医疗保健利用的可能性更高，包括门诊和住院治疗。对于使用医疗保健的人来说，PHI 对门诊支出有积极影响，但对门诊就诊次数没有影响。在住院治疗的使用者中，PHI 对住院天数和支出的影响没有统计学意义。这些结果意味着需要政策选择来减轻 PHI 在门诊护理部门的道德风险效应。
