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KMID : 1031020190250020044
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Quality Improvement in Health Care
2019 Volume.25 No. 2 p.44 ~ p.55
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Impact of Changes in Medical Aid Status on Unmet Need and Catastrophic Health Expenditure: Data from the Korea Health Panel
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Kim Woo-Rim
Nam Chung-Mo
Lee Sang-Gyu
Park So-Hee
Kim Tae-Hyun
Park Eun-Cheol
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Abstract
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Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE).
Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status (‘MA to MA,’ ‘MA to MA Exit,’ ‘MA Exit to MA,’ and ‘MA Exit to MA Exit’) on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals.
Results: In 1,164 Medical Aid type I individuals, compared to the ‘MA to MA’ group, the ‘MA to MA Exit’ group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The ‘MA Exit to MA Exit’ group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the ‘MA to MA Exit’ group had higher likelihoods of CHE at the 10% standard.
Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I ‘MA Exit to MA Exit’ beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.
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KEYWORD
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Medical insurance, Social welfare, Health care utilization, Health service, Health care cost
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