종별 의료기관 외래 경증질환 약제비 본인부담 차등정책 효과분석 = An Analysis of Effects of Differential Coinsurance Policy and Utilization of Outpatients Care by Types of Medical Institutions

다국어 초록 (Multilingual Abstract)

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions.
Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis.
Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant.
Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

참고문헌 (Reference)

1 변진옥, "요양기관 종별 외래본인부담차등정책의 효과분석" 한국사회정책학회 21 (21): 35-55, 2014

2 유창훈, "외래 의료 이용에서 종별 의료기관 선택에 영향을 미치는 요인" 대한의사협회 55 (55): 898-910, 2012

3 김효정, "외래 본인부담률 인상이 외래 의료이용에 미친 영향" 을지대학교 대학원 2013

4 정채림, "상급종합병원 외래진료비 본인부담률 인상이 의료기관 유형 선택에 미치는 영향: 소득수준 차이를 중심으로" 한국보건경제정책학회 21 (21): 103-124, 2015

5 Song SY, "The difference of outpatient utilization by changing coinsurance rate on pharmaceutical cost" Seoul University 2016

6 Park EH, "The difference of outpatient utilization by changing coinsurance rate on pharmaceutical cost" Yeonsei University 2015

7 Ministry of Health and Welfare, "Plan on the re-establishment of functions of health care institutions" Ministry of Health and Welfare 2011

8 Chun KH, "Impact of increasing the level of copayments on the number of physician visits" 25 (25): 73-87, 1992

9 Lee EH, "Impact of increasing outpatient coinsurance rate of tertiary care hospitals on outpatient utilization: focusing on diabetes mellitus" Yeonsei University 2011

10 Park HK, "Impact of increasing outpatient coinsurance rate of tertiary care hospitals on outpatient utilization: focusing on acute respiratory infection and hypertension" Yeonsei University 2011

11 Kan M, "Effects of cost sharing on the demand for physician services in Japan: evidence from a natural experiment" 22 (22): 1-12, 2010

12 Um JO, "Comparisons of pre.post medical utilization by adaptation of pharmaceutical expenditure differential copayment system" Hanyang University 2016

13 Jung GT, "An analysis of the effect of increases in user prices on health care use and cost: the Korean experience" 8 : 61-113, 1992

14 Kim KH, "Adjustment method for tertiary hospital visits" Research Institute for Healthcare Policy, Korean Medical Association 2010