Park Soojin, Nam Jin Young
Department of Healthcare Management, Eulji University, Sungnam-si 13135, Korea.
Healthcare (Basel). 2022 Apr 15;10(4):742. doi: 10.3390/healthcare10040742.
This study aims to analyze the relationship between cognitive function and out-of-pocket cost of the state change of multiple chronic conditions in individuals aged 60 or older. Data from the 2014 to 2018 Korean Longitudinal Study of Aging were used for 2202 older adults who were cognitively “normal” at the start of the survey. Four status change groups were established (“Good → Good,” “Good → Bad,” “Bad → Good,” and “Bad → Bad”) according to the change in the number of chronic diseases. Generalized estimating equation modeling analyzed the association between these changes and out-of-pocket medical cost. Out-of-pocket cost was significantly higher among older adults with multiple chronic conditions (p < 0.0001). Total out-of-pocket medical cost and out-of-pocket cost for outpatient care and prescription drugs were significantly higher for Bad→ Bad or Good → Bad changes. Older adults with cognitive decline had significantly higher total out-of-pocket medical cost and out-of-pocket cost for prescription drugs. This study demonstrates the need to improve the multiple chronic conditions management construction model to enhance the health of older adults in Korea and secure national health care finances long-term. It provides a foundation for related medical and medical expenses-related systems.
本研究旨在分析60岁及以上老年人多种慢性病状态变化的认知功能与自付费用之间的关系。2014年至2018年韩国老年纵向研究的数据用于2202名在调查开始时认知“正常”的老年人。根据慢性病数量的变化建立了四个状态变化组（“好→好”、“好→坏”、“坏→好”和“坏→坏”）。广义估计方程模型分析了这些变化与自付医疗费用之间的关联。患有多种慢性病的老年人自付费用显著更高（p<0.0001）。对于“坏→坏”或“好→坏”的变化，自付医疗总费用以及门诊护理和处方药的自付费用显著更高。认知功能下降的老年人自付医疗总费用和处方药自付费用显著更高。本研究表明，需要改进多种慢性病管理建设模式，以促进韩国老年人的健康并长期保障国家医疗保健财政。它为相关医疗和医疗费用相关系统提供了基础。
