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KMID : 1170320210270020095
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Korean Journal of Health Economics and Policy
2021 Volume.27 No. 2 p.95 ~ p.120
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The Effects of Out-of-Pocket Cost Change on Healthcare Utilization for the Elderly Outpatients in Korea
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Kim Woo-Hyeon
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Abstract
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Since 2018, out-of-pocket payments for the elderly outpatient services costing from 15,000 KRW to 20,000 KRW in clinics in Korea were reduced from 30% to 10% of total spending. This study analyzes how this out-of-pocket change affects outpatient service utilization of the elderly. Analyzing Korea Health Panel Survey from 2012 to 2018, I identified whether the elderly are more likely to utilize services over 15,000 KRW (the threshold at which an out-of-pocket payment increased significantly until 2017) and the sicker elderly patients are benefited after the policy change. In addition, a bunching mass just before the threshold is examined to identify whether the mass disappears after the 2018 policy change.
Logistic regression results show that the elderly patients, especially the sicker elderly measured by self-assessed health status, are more likely to utilize services over 15,000 KRW. The bunching mass at the notch until 2017 also disappeared, meaning that the financial burden at the threshold 15,000 KRW lessened for the elderly. The difference-in-difference estimation results confirm that the finding is robust, comparing changes in outpatient visits among the elderly and the non-elderly.
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KEYWORD
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elderly outpatient care, out-of-pocket payments, bunching analysis, Korea Health Panel, health insurance coverage expansions in Korea
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