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KMID : 1031020200260020095
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Quality Improvement in Health Care
2020 Volume.26 No. 2 p.95 ~ p.103
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A Study on the Applicability of the Population-Based Health Care Model: Focusing on Social Cooperative-type Medical Clinics in a Local Area
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Lee Keun-Jung
Oh Ju-Yeon
Lee Da-Hee
Hahm Myung-Il
Lee Jin-Yong
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Abstract
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Purpose: This study was to examine whether a health care model that provides comprehensive medical services based on population groups to members of the medical cooperative is applicable as a policy alternative in terms of medical use and cost.
Methods: Data were derived from National Health Insurance claim data in 2019. We compared the medical volume and expenses of patients who visited social cooperative-type medical clinics with other patients, control group who visited other clinics in a local area.
Results: The average number of visit days was 25.3 days in social cooperative-type medical clinics, more than 24.2 days in the control group (p=.004). However, the average medical cost per visit was KRW 46 thousand in social cooperative-type medical clinics, which was significantly lower than KRW 51 thousand in the control group (p<.001), and the total medical cost was also KRW 16.1 billion in social cooperative-type medical clinics and KRW 16.9 billion in the control group.
Conclusion: We identified that a population-based health care model might change patients' behaviors to health care services and decrease total medical cost. Further population based experiment is needed to develop alternative healthcare model.
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KEYWORD
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Population health management, Disease management, Cost control
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