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KMID : 0387320210310010125
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Korean Journal of Health Policy and Administration
2021 Volume.31 No. 1 p.125 ~ p.139
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The Effect of Residential Migration on the Utilization and Accessibility of Medical Care
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Lee Woo-Ri
Choi Yong-Seok
Lee Gyeong-Min
Kim Li-Hyen
Yoo Ki-Bong
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Abstract
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Background: In Korea, the health gap widens due to the number of medical resources and access to medical services betweenmetropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization andaccessibility.
Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversedprobability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimationequation.
Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory caresensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the totalmedical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease.
Conclusion: This study identified that between the residents who continued to reside in the region and the migrants, there weresignificant differences in the medical accessibility, quality of primary care, and unmet medical need.
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KEYWORD
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Residential migrant, Health gap, Medical utilization, Medical accessibility, Marginal structural model, Two-part model, Generalized estimating equations, NHIS-National Sample Cohort Database
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