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KMID : 1170320210270040001
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Korean Journal of Health Economics and Policy
2021 Volume.27 No. 4 p.1 ~ p.26
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The Effect of Medical aid Benefit on Preventable Hospitalization: Analysis of the Korean Medical Panel Survey
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Jung Youn
Jeon Bo-Young
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Abstract
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In this study, we analyzed the impact of the medical aid benefit on preventable hospitalization using the Korea Medical Panel 2016-2018. We adopted propensity score matching method using gender, age, disability, and co-morbidity indices to focus on the effects of medical aid benefits under similar health risks, and the final participants were 5,648 (1,412 Medical aid, 4,236 National Health Insurance). Preventable hospitalization was defined as hospitalization due to Ambulatory Care Sensitive Conditions (ACSCs). The analysis results showed that the number of outpatient visits, hospitalization rate, annual hospitalization days, and preventable hospitalization rate were significantly higher in the medical aid group. Panel regression showed that preventable hospitalization was significantly higher among the medical aid group, even after adjusting predisposing, enable, and need factors. We found the same pattern within the lower 20% of income level and patients with chronic conditions, but not in the diabetic patients. Additionally, the unmet healthcare needs for economic reasons attenuated the effect of medical aid, in which preventable hospitalization was increasing.
Assuming that preventable hospitalization due to ACSCs represent the quality of primary care, medical aid recipients are not guaranteed the quality of care, even though they use more outpatient services. This study is meaningful in that it demonstrated the necessity of improving the quality of health care in the medical aid group based on empirical analysis.
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KEYWORD
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Medical aid, Preventable Hospitalization, Quality of Care in Primary Care, Chronic conditions, Korean Health Panel
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