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KMID : 0897520010060010081
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Journal of Korean Association of Social Psychiatry
2001 Volume.6 No. 1 p.81 ~ p.92
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Health Service Utilization of Schizophrenic Patients under the Medical Aid Program in Korea
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Suh Soo-Kyung
Shin Young-Jeon
Nam Jung-Hyun
Lim Min-Kyung
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Abstract
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Objective: To understand the trend in the numbers of schizophrenic patients, treatment prevalence, composition and health care utilization of schizophrenic patients under the Medical Aid Program(Sch-MA) from 1992 to 1998, and to provide basic information necessary to establish and conduct the Medical Aid Program.
Method: The analysis is based on claims data of the Medical Aid Program from 1992 to 1998.
Results: 1) The number of schizophrenic patients among of beneficiaries of the Medical Aid Program are 24,373 in 1992, and has gradually increased to 32,258 in 1998. The treatment prevalence is 1.12 per 100 persons in 1992, and has gradually increased to 2.44 per 100 persons. Sex and age differences are both present. Treatment of men through Sch-MA is more prevalent than that of women, and the prevalence of treatment of patients in the age bracket 30-39 is the highest.
2) Sch-MA is composed of more male than female patients, and this trend is more prominent in patients that used admission services. Among patients that used outpatient services, younger groups have increased in size gradually. Among patients that used outpatient services, institutional residents form the largest group. However, the number of Sch-MA(type-1) patients has increased from year to year.
3) Service utilization rates, visit days per person, prescribing days per persons, and the medical costs per person in utilization of admission services have increased since 1995, and was highest in 1996 and 1997. In contrast, the utilization of outpatient services, service utilization rates, visit days per person, prescribing days per person, and medical costs per person have decreased since 1995. Utilization of admission services is highest among 50-59 years-olds, and utilization of outpatient services is highest among 30-39 years-olds, with 40-49 years-olds utilization being higher than that of 50-59 years-olds. Utilization of admission services is highest among those utilizing type-1 household, and utilization of outpatient services is highest among the institutional residents.
Conclusion: The proportion of schizophrenic patients among the Medical aid clients and the cost of service utilization is increasing continually. Therefore the importance of effective policy and management for Sch-MA is also increasing. Especially, the rapid increase in the utilization of admission services and the rapid decrease in the utilization of outpatient services since 1995 which has been observed, may be due to policy factors such as the increase in the number of beds and the prolongation of the duration of service utilization.
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KEYWORD
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Medical Aid Program, Schizophrenia, Health service utilization
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