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全民公共保险制度下,糖尿病患者补充私人医疗保险与就诊医师办公室和医院门诊部的关系。

Association between supplementary private health insurance and visits to physician offices versus hospital outpatient departments among adults with diabetes in the universal public insurance system.

机构信息

Graduate School of Healthcare Management and Policy, The Catholic University of Korea, Seoul, Korea.

International Institute of Health, Seoul, Korea.

出版信息

PLoS One. 2018 Apr 13;13(4):e0192205. doi: 10.1371/journal.pone.0192205. eCollection 2018.

Abstract

BACKGROUND

Diabetes mellitus is a chronic disease with a high prevalence across the world as well as in South Korea. Most cases of diabetes can be adequately managed at physician offices, but many diabetes patients receive outpatient care at hospitals. This study examines the relationship between supplementary private health insurance (SPHI) ownership and the use of hospitals among diabetes outpatients within the universal public health insurance scheme.

METHODS

Data from the 2011 Korea Health Panel, a nationally representative sample of Korean individuals, was used. For the study, 6,379 visits for diabetes care were selected while controlling for clustered errors. Multiple logistic regression models were used to examine determinants of hospital outpatient services.

RESULTS

This study demonstrated that the variables of self-rated health status, comorbidity, unmet need, and alcohol consumption significantly correlated with the choice to use a hospital services. Patients with SPHI were more likely to use medical services at hospitals by 1.71 times (95% CI 1.068-2.740, P = 0.026) compared to patients without SPHI.

CONCLUSIONS

It was confirmed that diabetic patients insured by SPHI had more use of hospital services than those who were not insured. People insured by SPHI seem to be more likely to use hospital services because SPHI lightens the economic burden of care.

摘要

背景

糖尿病是一种在全球范围内普遍存在的慢性疾病,在韩国也不例外。大多数糖尿病病例可以在医生办公室得到充分管理,但许多糖尿病患者在医院接受门诊治疗。本研究考察了在全民公共健康保险计划下,补充私人健康保险(SPHI)拥有情况与糖尿病门诊患者使用医院之间的关系。

方法

本研究使用了来自韩国全国代表性样本的 2011 年韩国健康小组的数据。为了研究,在控制了聚类误差的情况下,选择了 6379 次糖尿病护理就诊。使用多变量逻辑回归模型来检验医院门诊服务的决定因素。

结果

本研究表明,自我评估的健康状况、合并症、未满足的需求和饮酒等变量与选择使用医院服务显著相关。与没有 SPHI 的患者相比,拥有 SPHI 的患者使用医院医疗服务的可能性高 1.71 倍(95%CI 1.068-2.740,P = 0.026)。

结论

本研究证实,拥有 SPHI 的糖尿病患者比没有 SPHI 的患者更倾向于使用医院服务。拥有 SPHI 的人似乎更有可能使用医院服务,因为 SPHI 减轻了医疗护理的经济负担。

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