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KMID : 0387319990090040001
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Korean Journal of Health Policy and Administration
1999 Volume.9 No. 4 p.1 ~ p.14
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Magnitude of Patient´s Cost-sharing for Hospital Services in the national Health Insurance in Korea
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Kim Chang-Yup
Kim Yong-Ik
Lee Jin-Seok
Kang Gil-Won
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Abstract
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The purpose of this study was to estimate the magnitude of patient´s actural cost-sharing for hospital services in the National Health Insurance which has been estimated with only a few hospitals or limited number of patients. Also we aimed at analysis of factors influencing the magnitude. Sources of analyzed data were two databases, 1997 medical benefits record of the National Federation of medical Insurance and 1997 Statistics for Hospital Management from the Korea Institute of Health Services Management(KIHM). We merged two databases and related records for 224 hospitals, based on the identification details of each hospital.
The average percent of patients´ cost-sharing was 51.7% of total hospital revenues from the insurance, with 40.3% of revenue in inpatient and 67.4% in outpatients, respectively.
The contributing hospital factors to the magnitude of cost-sharing were size of hospitals, teaching status, location, number of employed physicians, etc. Larger and university hospital/ urban location, and with more physicians were positively correalted with higher level of cost-sharing. Additionally, the higher the expenses of inpatient´s treatment was, the higher the size of patient´s cost-sharing was.
These findings suggest that present level of patient´s cost-sharing is quitely high and it is urgent to reduce the patient´s cost-sharing to the reasonable level.
It would be necessary to extend the coverage of insurance benefits and to develop policies focusing on larger hospitals and inpatient services.
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KEYWORD
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Cost-sharing, National Health Insurance
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