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The impact of change from copayment to coinsurance on medical care usage and expenditure in outpatient setting in older Koreans
Author(s) -
Bae Byoungjun,
Choi Bo Ram,
Song Inmyung
Publication year - 2017
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.2416
Subject(s) - copayment , reimbursement , cost sharing , medicine , beneficiary , medical care , health care , health insurance , national health insurance , inpatient care , family medicine , emergency medicine , environmental health , business , nursing , finance , economics , population , economic growth
Summary Patient cost‐sharing change was implemented on August 1, 2007, for outpatient care in the clinic setting in Korea from copayment to coinsurance. This study aims to estimate the effect of the policy change on medical care usage and expenditure in older Koreans. By using national health insurance claims data from the Health Insurance Reimbursement Assessment Service, this study analyzed the entire 137 million claims for a total of approximately 4.1 million patients aged 60 to 69 years who had been diagnosed and/or treated for outpatient care in clinics from January 1, 2007, to December 31, 2008. Medical care usage was defined as the proportion of all beneficiaries in each group who visited clinics and the mean number of visit days per beneficiary. Medical care expenditure per visit day was expressed as total costs, reimbursed amount, and patient's out‐of‐pocket payment. Data on January through June of 2008 were analyzed as compared with the same months of 2007. Raw difference‐in‐difference and multiple regression analyses were performed. The interaction coefficients, which measured the impact of cost‐sharing change, was −0.078 in model 1 and −0.039 in model 2 ( P < .0001). In conclusion, a cost‐sharing change from copayment to coinsurance reduced medical care usage and expenditure.