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엄진영(Eom Jinyoung),남승희(Nam Seunghui),김하경(Kim Hagyeong) 한국농촌경제연구원 2015 한국농촌경제연구원 기본연구보고서 Vol.- No.-
This paper is aimed towards evaluating the role of integrated care, which couples health care and social welfare programs, for the elderly in rural areas in Korea. This integrated care system can reduce the cost through eliminating the unnecessary cost that appears when tow programs (i.e. health care and social welfare programs) are separately considered. Moreover, this integrated care system is highly required since elderly recipients of a health care program mostly have needs of social welfare services coincidentally or vice versa. Though those two programs are traditionally provided separately in Korea, some efforts to integrate health care and welfare programs have recently been made. Empirical studies in the U.S. and European countries show that the integrated care system improves care recipients’ satisfaction on services and quality of life. Moreover, the empirical studies suggest that the integrated care system is able to decrease the utilization of hospitals and the cost of services. However, it is still controversial that this system is effective and efficient in terms of cists and mortality. Despite recent studies reporting the integrated care system in the United States or European countries, it has still remained elusive how to evaluate the integrated care system for the elderly in rural areas in Korea. Until recently most of previous studies evaluated the effect of an integrated care program by only measuring the care recipients’ satisfaction. The evaluation of recipients’ satisfaction is not sufficient to judge the effectiveness and efficiency of an integrated care program because the care recipients’ satisfaction is very subjective and contains limited information. This implies the necessity to establish a standard, which may allow for evaluating the efficiency and effectiveness of the integrated care program, by estimating not only the care recipients’ satisfaction but also economic evaluation. To quantitatively understand the role of the integrated care system on the economy of Korea, I consider the datasets such as costs, hospital utilization, health conditions, mortality, considering or excluding an integrated care program. These datasets need to be based on randomized controlled trials. However as these datasets are not available publicly to be utilized in Korea, I take into account an alternative method to evaluate the economic effect of an integrated care program. In particular, in this paper I employed the cost-effectiveness method with alternative methods to the design of traditional randomized controlled trial in order to evaluate the economic effect of an integrated care program, which combines health care and social welfare programs, for the elderly in rural areas in Korea. The data were collected directly from two rural provinces where an integrated care program for the elderly is implemented. Specifically, I used the collected data such as integrated care recipients’ satisfaction, integrated care recipients’ demographic and socio-economic characteristics, frequency (or hours) of integrated care services to receive, and integrated care recipients’ health status, Based on the analysis using aforementioned data, this study suggests the incremental cost-effectiveness of the integrated care program, which combines health care and social welfare programs, and also provides the optimal trajectory of cost for an integrated care program for the elderly This work sheds light on the integrated care program which allows for effectiveness of economic cost and improving the life of the elderly.
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