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KMID : 0387320050150020016
Korean Journal of Health Policy and Administration
2005 Volume.15 No. 2 p.16 ~ p.36
The Effect of Payment Method of Community Medical Provider on Medical Care Use of Community Residents
Lim Jae-Young

Abstract
Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient¡¯¡¯s decision making process of purchasing medical care. Based on this notion, doctor¡¯¡¯s reimbursement method has been suggested as an effective policy device of improving efficiency of patient¡¯¡¯s medical care use by way of its affecting doctor¡¯¡¯s practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient¡¯¡¯s medical care use, but doctor¡¯¡¯s practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor¡¯¡¯s characteristics of reimbursement method on community patient¡¯¡¯s medical care use under the control of patient¡¯¡¯s socio-demographic characteristics and community doctor¡¯¡¯s practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman¡¯¡¯s two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor¡¯¡¯s portion of practice revenue determined by prospective method out of total revenue increases, the community patient¡¯¡¯s total out-of-pocket medical cost decreases. This results suggest, as doctor¡¯¡¯s practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor¡¯¡¯s practice pattern and by which his/her patient¡¯¡¯s use of medical care would decrease.
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