Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea.
Institute for Digital Life Convergence, Dankook University, Cheonan, Republic of Korea.
Medicine (Baltimore). 2022 Aug 12;101(32):e29865. doi: 10.1097/MD.0000000000029865.
This empirical study identifies the negative aspects of private health insurance (PHI) by analyzing the association between subjective health conditions, 2 weeks of outpatient care, chronic diseases, and hospitalizations for 1 year. We used frequency analysis, χ2 testing, an analysis of variance, and logistic and multiple logistic regression models to analyze the association between PHI and subjective health conditions, outpatient care, chronic disease status, and hospitalization. The PHI group had good subjective health but had more outpatient care for 2 weeks. There were few chronic diseases in the private insurance group, and there was no significant difference in hospitalizations for 1 year. Hospitalization may occur when essential medical care is required, regardless of health insurance type. This study confirmed that as the PHI lowers the burden of personal medical expenses, the PHI can lead to an increase in the medical resource expenditures on the outpatient medical service and higher public health costs. The government should work to redefine the role of private and national health insurance. Also, the effectiveness of PHI should be reevaluated so that it does not lead to indiscriminate use of medical services by minimizing the burden of private insurance.
本实证研究通过分析主观健康状况、2 周门诊护理、慢性病以及 1 年住院治疗之间的关联，确定了私人医疗保险 (PHI) 的负面方面。我们使用频率分析、卡方检验、方差分析以及逻辑和多项逻辑回归模型来分析 PHI 与主观健康状况、门诊护理、慢性病状况和住院治疗之间的关联。PHI 组的主观健康状况良好，但 2 周的门诊护理需求更多。私人保险组的慢性病较少，但 1 年的住院治疗没有显著差异。当需要基本医疗时，可能会住院，而与健康保险类型无关。本研究证实，随着 PHI 降低个人医疗费用的负担，PHI 可能导致门诊医疗服务的医疗资源支出增加，公共卫生成本上升。政府应努力重新定义私人和国家健康保险的作用。此外，应通过最小化私人保险的负担来重新评估 PHI 的效果，以避免无差别地使用医疗服务。
