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KMID : 1170320210270030061
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Korean Journal of Health Economics and Policy
2021 Volume.27 No. 3 p.61 ~ p.88
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Impacts of the use of general hospital-level institutions on medical expenses of mild chronic patients
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Bae Seo-Woo
Ahn Jeong-Hoon
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Abstract
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The study observed an impact of mild chronic patients visiting general hospital on their annual medical expenses, using Korea Health Panel data. In order to reduce selection bias, we observed the difference of medical costs between general hospital used group and unused group using propensity score matching. The subjects were patients who were mainly diagnosed with diabetes or hypertension in outpatient in 2015, who don’t have any complications and their health status relatively fair ? CCI ≤ 1 -, were classified into general hospital used and unused groups in 2015. The difference in 2015-2017 medical expenses between two groups were analyzed. As a result, among the patients with diabetes, general hospital visiting significantly increased medical costs in 2015~17 compared to no visiting group (=0.528, p<0.001; =0.278, p<0.001; =0.209, p<0.01). Among the patients with hypertension, general hospital visited patients showed significantly higher medical costs only in 2015 (=0.213, p<0.01). However, after reanalyzing the data with top 5% high cost patients trimmed, the impact of visiting general hospital for hypertension became insignificant in 2015 (=0.078, p=0.189) whereas significant impacts of general hospital visiting among the patients with diabetes did not change. According to the results of the study, the use of general hospital significantly increased medical costs for patients with diabetes patients beyond the “additional rate by size of medical institution”, and this impact lasted for more than 2 years, whereas there was no significant impact remained for the patients with hypertension after trimming high cost patients (top 5%).
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KEYWORD
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Health care delivery system, Mild chronic diseases, Annual medical expenditure, Propensity score matching, Korea Health Panel Study
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