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KMID : 1124020180340010055
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Korean Social Security Studies
2018 Volume.34 No. 1 p.55 ~ p.77
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Comparison of Healthcare Utilization between National Health Insurance and Medical Aid Program: A Propensity Score Matching Approach
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Kim Jin-Hyun
Yim Eun-Shil
Bae Hyun-Ji
Ko Young
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Abstract
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The objective of this study is to compare the amount of healthcare services utilization between the National Health Insurance and the Medical Aid Program and suggest the target of resource allocation policy. Data were extracted from the national health insurance claims database for the year 2002 and 2010. A propensity score matching with income, age, gender, and seven major diseases was applied to control the high risk factors of medicaid beneficiaries. The two equivalent subjects of 41,625 persons in the Medical Aid Program and 41,625 persons in the National Health Insurance were sampled through propensity score matching. The data were analyzed using descriptive statistics and regression analysis to estimate the total expense, inpatient expense, outpatient expense, medication expense, length of stay, and the number of visits. The results showed that the ratio, in terms of per capita utilization, of the Medical Aid Program to the National Health Insurance was 1.5 in total medical cost, 1.9 in hospitalization cost, 1.3 in outpatient cost, 1.4 in medication cost, 2.9 in hospitalization days, 1.2 in outpatient visits, respectively. The deterministic analysis of price and quantity indicated that main cost drivers in the Medical Aid Program were the long length of stay in hospitals and low co-payment, which would be the future policy target of cost containment in the Medical Aid Program
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KEYWORD
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National Health Insurance, Medical Aid Program, propensity score matching approach, health utilization, co-payment
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