The Effect of Private Health Insurance on Medical Care Use and Out-of-Pocket Medical Expenditure : Focused on the Older Population

2019 ◽  
Vol 15 (3) ◽  
pp. 75-102
Author(s):  
Serah Shin ◽  
Author(s):  
Yoon-Sun Jung ◽  
Young-Eun Kim ◽  
Dun-Sol Go ◽  
Radnaabaatar Munkhzul ◽  
Jaehun Jung ◽  
...  

In South Korea, people may increase their medical coverage by purchasing private health insurance to augment low coverage provided by the National Health Insurance (NHI). Frequent and excessive use of medical care by those with private health insurance is an issue, especially for musculoskeletal disorders that require excessive care and contribute to moral hazard. In South Korea, since private health insurance is structurally linked to the scope of coverage with public health insurance, this increased use of medical care may adversely affect public health insurance finances. This study aimed to analyze the effects of private health insurance on medical care use for patients with musculoskeletal disorders. We used the Korea Health Panel 2014 to 2015 data that included 5622 participants who used medical care for musculoskeletal disorders in 2015. Two groups were created: those who purchased private health insurance ( n = 3588) and those without private insurance ( n = 2034). We compared their medical utilization using logistic regression, negative binomial regression, and multiple linear regression to determine the associations of private health insurance with medical care use. Medical expenditures by private health insurance purchasers were higher than those of non-purchasers for outpatient care ( P < .001), but no differences were found for inpatient care. Our findings suggest that the expansion of private health insurance further burdened the NHI financially, ultimately increasing the burden of medical expenses for the population. Research should implement demonstration studies with different groups of diseases.


2003 ◽  
Vol 60 (2_suppl) ◽  
pp. 3S-75S ◽  
Author(s):  
Jack Hadley

Health services research conducted over the past 25 years makes a compelling case that having health insurance or using more medical care would improve the health of the uninsured. The literature's broad range of conditions, populations, and methods makes it difficult to derive a precise quantitative estimate of the effect of having health insurance on the uninsured's health. Some mortality studies imply that a 4% to 5% reduction in the uninsured's mortality is a lower bound; other studies suggest that the reductions could be as high as 20% to 25%. Although all of the studies reviewed suffer from methodological flaws of varying degrees, there is substantial qualitative consistency across studies of different medical conditions conducted at different times and using different data sets and statistical methods. Corroborating process studies find that the uninsured receive fewer preventive and diagnostic services, tend to be more severely ill when diagnosed, and receive less therapeutic care. Other literature suggests that improving health status from fair or poor to very good or excellent would increase both work effort and annual earnings by approximately 15% to 20%.


2001 ◽  
Vol 30 (3) ◽  
pp. 616-621 ◽  
Author(s):  
Yoko Izumi ◽  
Ichiro Tsuji ◽  
Takayoshi Ohkubo ◽  
Aya Kuwahara ◽  
Yoshikazu Nishino ◽  
...  

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