Research in Community and Public Health Nursing

Original Articles

The Effect of Copayment on Medical Aid Beneficiaries in Korea: Jin Joo Oh, Jeong Myung Choi, Hyun Joo Lee; J Korean Acad Community Health Nurs. 2015;26(1):11-17. Published online March 31, 2015; DOI: https://doi.org/10.12799/jkachn.2015.26.1.11

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PURPOSE
This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment.
METHODS
This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008.
RESULTS
There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001).
CONCLUSION
Copayment does not seem to be a great influencing factor on beneficiaries'accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.

Citations

Citations to this article as recorded by

Impact of co-payment for outpatient utilization among Medical Aid beneficiaries in Korea: A 5-year time series study
Ki-Bong Yoo, Hong-Uk Ahn, Eun-Cheol Park, Tae Hyun Kim, Sun Jung Kim, Jeoung A Kwon, Sang Gyu Lee
Health Policy.2016; 120(8): 960. CrossRef

The Effects of Case Management for Medicaid on Healthcare Utilization by the Medicaid System: Seung Joo Lim; J Korean Acad Community Health Nurs. 2010;21(4):375-385. Published online December 31, 2010; DOI: https://doi.org/10.12799/jkachn.2010.21.4.375

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Abstract PDF

PURPOSE
This study examined the effects of case management (CM) for Medicaid on healthcare utilization considering the Medicaid system.
METHODS
Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare the effects on healthcare utilization between the CM group and the non-CM group. The subjects were 535 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006.
RESULTS
The outpatient days and medication days of the CM group decreased significantly more than those of the non-CM group with the copayment system. There were no significant differences of healthcare utilization between the CM group and the non-CM group with the designated doctor system.
CONCLUSION
CM worked effectively on Medicaid beneficiaries' outpatient healthcare utilization with the copayment system. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, future studies are needed to develop strategies to reduce hospitalization and Medicaid beneficiaries' outpatient healthcare utilization with the designated doctor system.

Citations

Citations to this article as recorded by

The Effect of Case Management Services for High-risk Medicaid Beneficiaries
Young Jin Ahn, Yun-Kyoung Choi
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(8): 5430. CrossRef
The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases
Min Jung Kim, Young-Ha Cho, Nam Hee Park
Journal of Korean Academy of Community Health Nursing.2015; 26(3): 278. CrossRef
A Study on Influential Factors on Satisfaction with the Use of Medical Services by the Qualified Recipients of Medical Aid(focusing on the period after the introduction of the selected medical center system)
Jin-Woo Lee, Se-I Yang, Kwang-Hwan Kim
Journal of Digital Convergence.2014; 12(3): 289. CrossRef
Effectiveness of Community-based Case Management for Patients with Hypertension
Soon-Nyoung Yun, In-Sook Lee, Jin Hyun Kim, Young Ko
Journal of Korean Academy of Community Health Nursing.2014; 25(3): 159. CrossRef
The Effects of the Designated Doctor System on the Health of Medical Aid Beneficiaries
Jeongmyung Choi, Jinjoo Oh
Journal of Korean Academy of Community Health Nursing.2012; 23(4): 438. CrossRef

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