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KMID : 1002520200140010147
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Korean Journal of Health Service Management
2020 Volume.14 No. 1 p.147 ~ p.159
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Status and Characteristics of Applying a Copayment Ceiling for the Elderly
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Park Cho-Yeal
Park Young-Hee
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Abstract
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Objectives: This study is the human factors and disease factors of the copayment system for the elderly (>65 years old) and to identify does the current status and characteristics of the applied elderly and conducted to provide basic data.
Methods: Sample cohort data from the National Health Insurance Corporation database, from the years 2012-2015, were analyzed of 21,772 elderly people over the copayment ceiling.
Results: The ratio of those who exceeded the copayment ceiling system rose sharply from progressive rates of 3.39% in 2012, 3.69% in 2013 and 5.03% in 2014, to rates of 37.13% from 2013. Factors identified that affect the instances of being over the copayment ceiling were: age, income group, region, severity, disability, sickness distribution, inpatient days, and outpatient days.
Conclusions: The reorganization of the copayment ceiling system in 2014 favored low-income families of the elderly, but in 2015, the proportion of elderly was low (only 5.78%). The government's policies needs to change to allow for the amount of the deductible upper limit for low- and middle- income groups to be further subdivided in order for the elderly to receive more deductibles.
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KEYWORD
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Copayment Ceiling System, Retirees, Elderly, National Health, Insurance Corporation Big data
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