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JAMA Intern Med. 2015 Mar;175(3):393-8. doi: 10.1001/jamainternmed.2014.7582.
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Impact of Medicaid copayments on patients with cancer: lessons for Medicaid expansion under health reform.医疗补助共付额对癌症患者的影响:医疗改革下扩大医疗补助的经验教训。
Med Care. 2011 Sep;49(9):842-7. doi: 10.1097/MLR.0b013e31821b34db.
3
[The effect of outpatient cost sharing on health care utilization of the elderly].[门诊费用分担对老年人医疗保健利用的影响]
J Prev Med Public Health. 2010 Nov;43(6):496-504. doi: 10.3961/jpmph.2010.43.6.496.
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Increased ambulatory care copayments and hospitalizations among the elderly.老年人的门诊医疗自付额增加和住院率增加。
N Engl J Med. 2010 Jan 28;362(4):320-8. doi: 10.1056/NEJMsa0904533.
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Copayments for ambulatory care in Germany: a natural experiment using a difference-in-difference approach.德国门诊护理共付额:基于双重差分法的自然实验研究。
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Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage.韩国三十年的国民健康保险:实现全民医保覆盖的经验教训。
Health Policy Plan. 2009 Jan;24(1):63-71. doi: 10.1093/heapol/czn037. Epub 2008 Nov 12.
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Health Aff (Millwood). 2008 Jan-Feb;27(1):103-12. doi: 10.1377/hlthaff.27.1.103.
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The impacts of the State Children's Health Insurance Program on children who enroll: findings from ten states.儿童健康保险计划对参保儿童的影响:来自十个州的调查结果
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对韩国6岁以下住院儿童共付额豁免政策效果的评估。

An evaluation on the effect of the copayment waiver policy for Korean hospitalized children under the age of six.

作者信息

Kwak Sook Young, Yoon Seok-Jun, Oh In-Hwan, Kim Young-Eun

机构信息

Bureau of Welfare Administration Support, Ministry of Health and Welfare, Sejong, South Korea.

Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea.

出版信息

BMC Health Serv Res. 2015 Apr 20;15:170. doi: 10.1186/s12913-015-0836-x.

DOI:10.1186/s12913-015-0836-x
PMID:25928166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4422598/
Abstract

BACKGROUND

In January 2006, the Korean government implemented a copayment waiver policy for hospitalized children under the age of 6 years to reduce the economic burden on patients. This policy was implemented from 2006 to 2007 in Korea and involved hospitalized children under the age of 6 years. The goal of this study is to evaluate the effect of the copayment waiver policy on health insurance beneficiaries.

METHODS

The change in medical service utilization before and after the policy implementation was analyzed using data from the national health insurance corporation (NHIC) and compared with medical aid beneficiaries who were already exempt from copayment. The "difference in difference" method was applied to determine the net effect of the copayment waiver policy.

RESULTS

The net effect of policy implementation on NHIC beneficiaries was unclear by the "difference in difference" method because the number of inpatient days and hospital expenditure after policy implementation showed opposite results. The copayment waiver policy did not decrease the intensity of health care utilization when compared with the medical aid beneficiaries group. Among the NHIC beneficiaries, patients who utilized medical services for fatal disease and those with the low premiums group were more affected by the policy.

CONCLUSIONS

The net effect of copayment waiver policy remains unclear. Therefore, further studies are needed to determine the effects of policies implemented to reduce the economic burden on patients, such as the herein-described copayment waiver policy.

摘要

背景

2006年1月,韩国政府实施了一项针对6岁以下住院儿童的共付费用豁免政策,以减轻患者的经济负担。该政策于2006年至2007年在韩国实施,涉及6岁以下的住院儿童。本研究的目的是评估共付费用豁免政策对健康保险受益人的影响。

方法

利用国民健康保险公团(NHIC)的数据,分析政策实施前后医疗服务利用情况的变化,并与已免除共付费用的医疗救助受益人进行比较。采用“差异中的差异”方法来确定共付费用豁免政策的净效果。

结果

采用“差异中的差异”方法,政策实施对NHIC受益人的净效果不明确,因为政策实施后的住院天数和医院支出呈现相反的结果。与医疗救助受益人组相比,共付费用豁免政策并未降低医疗保健利用强度。在NHIC受益人中,因致命疾病使用医疗服务的患者和低保费组受该政策影响更大。

结论

共付费用豁免政策的净效果仍不明确。因此,需要进一步研究以确定为减轻患者经济负担而实施的政策的效果,如本文所述的共付费用豁免政策。