Kwak Sook Young, Yoon Seok-Jun, Oh In-Hwan, Kim Young-Eun
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.
BMC Health Serv Res. 2015 Apr 20;15:170. doi: 10.1186/s12913-015-0836-x.
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.
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.
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.
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.
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。
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。
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。
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。