Kim Jennifer Ivy, Kim Sukil
Department of Public Health, Graduate School, The Catholic University of Korea, 222- Banpo-daero, Seocho-gu, 06591, Seoul, Korea.
Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222-Banpo-daero, Seocho-gu, 06591, Seoul, Korea.
BMC Health Serv Res. 2021 Jul 1;21(1):631. doi: 10.1186/s12913-021-06677-w.
The average annual healthcare expenditure among elderly patients in Korea is increasing rapidly in indirect healthcare sectors, requiring an understanding of factors related to the use of both formal and informal caregivers. This study analyzed the characteristics of caregiver use and caregiving costs among elderly patients hospitalized due to acute illness or exacerbation of chronic diseases.
A total of 819 study participants were selected from the 2017 Korea Health Panel Study Data. Replacement costing methods were applied to estimate the hours of informal caregiver assistance received by elderly inpatients. Elderly inpatients' predisposing, enabling, and need factors were studied to identify the relationship between caregiver uses, based on Andersen's behavior model. A two-part model was applied to analyze the factors related to care receipt and to estimate the incremental costs of care.
Elderly inpatients who used tertiary hospitals (OR: 2.77, p-value < 0.00) and received financial support (OR: 2.68, p-value < 0.00) were more likely to receive support from a caregiver. However, elderly inpatients living alone were lesser to do so (OR: 0.49, p-value < 0.00). Elderly inpatients with Medicaid insurance (β:0.54, p-value = 0.02) or financial aid (β: 0.64, p-value < 0.00) had a statistically positive association with spending more on caregiving costs. Additionally, financial support receivers had incremental costs of $627 in caregiving costs than nonreceivers.
This study presented significant socioenvironmental characteristics of formal and informal caregiver use and the related expenditures. Healthcare management plans that encompass multiple social levels should be implemented to ease the caregiver burden.
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韩国老年患者的年均医疗保健支出在间接医疗保健领域增长迅速，这需要了解与使用正式和非正式护理人员相关的因素。本研究分析了因急性疾病或慢性病加重而住院的老年患者使用护理人员的特征及护理成本。
从2017年韩国健康面板研究数据中选取了819名研究参与者。采用替代成本核算方法来估计老年住院患者接受非正式护理人员协助的时长。基于安德森行为模型，研究老年住院患者的诱发因素、促成因素和需求因素，以确定护理人员使用之间的关系。应用两部分模型分析与接受护理相关的因素，并估计护理的增量成本。
使用三级医院的老年住院患者（比值比：2.77，p值<0.00）和获得经济支持的患者（比值比：2.68，p值<0.00）更有可能获得护理人员的支持。然而，独居的老年住院患者获得支持的可能性较小（比值比：0.49，p值<0.00）。拥有医疗补助保险（β：0.54，p值=0.02）或获得经济援助（β：0.64，p值<0.00）的老年住院患者在护理成本支出方面存在统计学上的正相关。此外，获得经济支持的患者比未获得支持的患者在护理成本上有627美元的增量成本。
本研究呈现了正式和非正式护理人员使用的重要社会环境特征及相关支出。应实施涵盖多个社会层面的医疗管理计划，以减轻护理人员的负担。
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