Department of Health Policy and Management, Seoul National University College of Medicine, Seoul 03080, Korea.
Regional Emergency Care Center, Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea.
Int J Environ Res Public Health. 2018 Jun 22;15(7):1312. doi: 10.3390/ijerph15071312.
Korea has experienced an overall expansion of access to care in the past few decades, which necessitated the reconsideration of the role of the public health clinics (PHC) as a primary care provider. The recent controversy about the outpatient copayment waiver for the elderly in the PHC is in the same vein. This study compared the outpatient utilization of the PHC and private clinics, and investigated its factors. Data were acquired from the National Patient Sample in 2013. Compared with private clinics, the patients in the PHC were more elderly and had less severe conditions. Being elderly, the status of National Health Insurance (NHI) beneficiaries, less comorbidities, and low total claim costs were found to be factors for choosing the PHC over private clinics. These results suggest that the elderly, who are the main beneficiaries of copayment waivers in the PHC, are the most likely to use the outpatient service by the PHC. The functions of the PHC need to be rearranged according to the recent advancements in the health care system in Korea. Diverting the resources and efforts from outpatient care to functions that best serve the health of the population should be considered.
韩国在过去几十年中经历了医疗服务可及性的全面扩大，这使得重新考虑公共卫生诊所（PHC）作为初级保健提供者的角色变得必要。最近有关 PHC 老年门诊豁免的争议也属于同一范畴。本研究比较了 PHC 和私人诊所的门诊利用率，并调查了其影响因素。数据来自 2013 年的国家患者样本。与私人诊所相比，PHC 的患者年龄更大，病情更轻。研究发现，年龄较大、国民健康保险（NHI）受益人的身份、较少的合并症和较低的总索赔费用是选择 PHC 而不是私人诊所的因素。这些结果表明，PHC 门诊豁免的主要受益者老年人最有可能使用 PHC 的门诊服务。根据韩国医疗保健系统的最新进展，需要重新安排 PHC 的功能。应该考虑将资源和精力从门诊护理转移到最能促进人群健康的功能上。
