Research in Community and Public Health Nursing

Original Articles

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; J Korean Acad Community Health Nurs. 2015;26(3):278-291. Published online September 30, 2015; DOI: https://doi.org/10.12799/jkachn.2015.26.3.278

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PURPOSE
This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences.
METHODS
Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program.
RESULTS
There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution.
CONCLUSION
These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

Citations

Citations to this article as recorded by

A Two-step Clustering Approach for Measuring Socioeconomic Factors Associated with Cardiovascular Health among Older Adults in South Korea
Chi-Young Lee
Korean Journal of Adult Nursing.2020; 32(6): 551. CrossRef

The Effects of the Designated Doctor System on the Health of Medical Aid Beneficiaries: Jeong Myung Choi, Jin Joo Oh; J Korean Acad Community Health Nurs. 2012;23(4):438-445. Published online December 31, 2012; DOI: https://doi.org/10.12799/jkachn.2012.23.4.438

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Abstract PDF

PURPOSE
Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not.
METHODS
A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system.
RESULTS
After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not.
CONCLUSION
This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

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

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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