Effect of Private Health Insurance on Medical Expenditure and Unmet Medical Needs: Evidence from South Korea

2019 ◽  
Vol 19 (1) ◽  
pp. 693
Author(s):  
Hyoungshim Choi ◽  
Young-Il Jung
Author(s):  
Jeonghyun CHO ◽  
Eunmi LEE

Background: Healthcare utilization has progressively increased, especially among Medical Aid (MA) beneficiaries in South Korea. Recently, the focus of MA policy is shifting to long-term inpatient management. We aimed to identify the factors associated with inpatients’ medical service use among MA beneficiaries compared to National Health Insurance (NHI) beneficiaries. Methods: This secondary data analysis study used raw data collected from 2012 to 2014 by the Korea Health Panel Study, which is a national health survey conducted annually. Data from 3,869 participants were analyzed: 3,621 NHI beneficiaries and 248 MA beneficiaries. Multiple regression analysis and difference and slope difference tests were performed. Results: Age, education level, marital status, living with family, employment, disability, and unmet medical needs significantly influenced the length of hospital stay. Living with family, employment, disability, chronic illness, and unmet medical needs significantly influenced hospitalization costs. MA beneficiaries had longer hospital stay than did NHI beneficiaries (F=5.99, P=0.003); however, there was no difference in hospitalization costs. Among those with low education, longer hospital stay length was more frequent among MA beneficiaries. Conclusion: A future intervention model for MA inpatients should consider their service use patterns and characteristics. Most importantly, healthcare education should be provided according to MA patients’ education level to enable patients to make informed health-related decisions. An effort is needed to change the current hospitalization system by encouraging patients to utilize local community care service and by expanding community care and in-home healthcare services.  


2019 ◽  
Vol 50 (1) ◽  
pp. 82-94 ◽  
Author(s):  
Abay Asfaw ◽  
Toni Alterman ◽  
Brian Quay

Information on opioids obtained by workers is important for both health and safety. We examined the prevalence and total expenses of obtaining outpatient opioid prescriptions, along with associated sociodemographic, economic, and work characteristics, in national samples of U.S. workers. We used Medical Expenditure Panel Survey data (2007–2016) along with descriptive and multiple logistic regression. During the study period, an estimated 21 million workers (12.6%) aged 16 years or older obtained one or more outpatient opioid prescriptions, at an expense of $2.81 billion per year. Private health insurance covered half of the total opioid expenses for workers. The prevalence of obtaining opioid prescriptions was higher for women than for men, but men had higher opioid expenses. In addition, the prevalence of obtaining opioid prescriptions was higher for workers who were older; non-Hispanic white; divorced, separated, or widowed; and non-college-educated. There is an inverse relationship between family income and the likelihood of obtaining opioids. Compared to workers with private insurance, workers with public health insurance had higher expenses for opioid prescriptions. Finally, workers in occupations at higher risk for injury and illness – including construction and extraction; farming; service; and production, transportation, and material moving occupations – were more likely to obtain opioid prescriptions.


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