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Background: This study aimed to investigate the association between the Korean national health insurance coverage benefit extension policy and clinical outcomes of patients who were ventilated owing to various respiratory diseases.Methods: Data from 515 patients (male, 69.7%; mean age, 69.8±12.1 years; in-hospital mortality rate, 28.3%) who were hospitalized in a respiratory intensive care unit were retrospectively analyzed over five years.Results: Of total enrolled patients, 356 (69.1%) had one benefit items under this policy during their hospital stay. They had significantly higher medical expenditure (total: median, 23,683 vs. 12,742 USD, P&lt;0.001), out-of-pocket (median, 5,932 vs. 4,081 USD; P=0.008), and a lower percentage of out-of-pocket medical expenditure relative to total medical expenditure (median, 26.0% vs. 32.2%; P&lt;0.001). Patients without benefit items associated with higher in-hospital mortality (hazard ratio [HR], 2.825; 95% confidence interval [CI], 1.995–4.000; P&lt;0.001). In analysis of patients with benefit items, patients with three items (“cancer”, “tuberculosis,” and “disability”) had significantly lower out-of-pocket medical expenditure (3,441 vs. 6,517 USD, P&lt;0.001), and a lower percentage of out-of-pocket medical expenditure relative to total medical expenditure (17.2% vs. 27.8%, P&lt;0.001). They were associated with higher in-hospital mortality (HR, 3.996; 95% CI, 2.535–6.295, P&lt;0.001).Conclusions: Our study showed patients with benefit items had more medical resources and associated improved in-hospital survival. Patients with the aforementioned three benefit items had lower out-of-pocket medical expenditure due to the implementation of this policy, but higher in-hospital mortality.

acute and critical care

Association between the National Health Insurance coverage benefit extension policy and clinical outcomes of ventilated patients: a retrospective study