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KMID : 1170320150210020103
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Korean Journal of Health Economics and Policy
2015 Volume.21 No. 2 p.103 ~ p.124
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The Effect of Increase in Coinsurance Rate for Tertiary Hospital Visits on the Choice among Different Types of Medical Facilities Stratified by Income Levels in Korea
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Cheong Che-Lim
Lee Tae-Jin
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Abstract
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The increase in coinsurance rate for outpatient visits to tertiary hospitals was implemented in July 2009. The aims of the study were to assess the effect of the policy on the choice among different types of medical facilities and to stratify it by income levels. Subgroup analyses were performed in patients with minor illnesses, patients aged 65 and over, and patients younger than 65, respectively. Outpatient visit data of the National Health Insurance enrollees were collected from the Korea Health Panel data from 2008 to 2010. We used multinomial logit models of medical facility choice among outpatients. We found that the policy had a significant impact on the choice of medical facility types. The effect of the policy was higher among the lowest income quintile compared to the higher income quintiles. The subgroup analyses showed that the policy was more effective among those with minor illnesses or in the younger group, and the difference in the effect between the income groups was higher among the subgroups. Our findings suggest that policy-makers should employ diverse approaches to decrease unnecessary outpatient visits to tertiary hospitals regardless of the income level.
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KEYWORD
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Coinsurance, Outpatient care utilization, Price policy, Multinomial logit model, Minor illness, Age
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