ABSTRACT

This study addressed two differential cost-sharing polices in July 2009 and October2011 to check whether outpatients were affected by the policies in using healthcare services and to draw out implications for establishing more efficient medicalcare delivery system by easing the tendency towards big hospitals. In 2009, theco-payment rate for outpatients at tertiary care hospital was increased. In 2011, theco-payment rate for pharmaceutical services were increased when people get drugprescriptions at general hospital and tertiary care hospital for treating 52 specificdiseases. The study result showed that ‘time-after 2009 policy’, ‘the implementation of 2011policy’, and ‘time-after 2011 policy’ factors had impacts on reducing the number ofoutpatients and the amount of outpatients’medical expenses in tertiary carehospital. However, these policies were not appeared to be effective in increasingthe numbers of outpatients and the amount of medical expanses in clinics andhospitals. Based on this study, it’s not clear that decreased utilization of tertiary care hospitaland general hospital through co-payment polices has been converted to demandfor the small hospitals and clinics. These results imply that price policy such as differential cost-sharing intended to alter behaviors of demand side of health careservice has limited effect on functionalizing the level of medical institutions. Important implications for Korea from the study are two-folds. First, what we needmay not be the government’s leading role in increasing part-time work opportunitiesfor most women, but rather, common efforts by workers and employers togetherwith the entire society in deciding the future direction of the society modelwe want to pursue in the long run. Moreover, what types of roles women will beexpected to play in the future Korean society must also be decided upon. Therefore, not only labour policies, but also women, family, and welfare policiesshould be considered all together in harmony.

KEYWORD

Differential cost-sharing, price policy, demand for outpatients care, outpatient care utilization

REFERENCES(31)open

  1. [report] 대한의학협회 / 1979 / 의료보험진료체계수립(안)

  2. [jounal] 공방환 / 1995 / 보험진료체계 개편이 의료기관 종별 환자분포에 미친 영향분석 / 보건행정학회지 5 (1) : 31 ~ 58

  3. [jounal] 김효정 / 2013 / 외래 본인부담률 인상이 상급종합병원과 종합병원 외래 의료이용에 미친 영향 / 보건행정학회지 23 (1) : 19 ~ 34

  4. [report] 명재일 / 1991 / 의료전달체계 운영성과의 분석

  5. [jounal] 송건용 / 2001 / 의료전달체계의 개선방향 / 대한병원협회지 30 (1) : 105 ~ 114

  6. [jounal] 신현철 / 2013 / 고혈압 외래 진료비 관련 진료경향 분석 / 심사평가원 정책동향 7 (1) : 65 ~ 73

  7. [confproc] 오영호 / 2012 / 의료전달체계의 문제점과 정책과제 / 보건복지포럼 189 : 50 ~ 67

  8. [report] 이규식 / 2012 / 건강보험제도 및 의료공급체계의 발전을 위한 과제

  9. [thesis] 이은희 / 2012 / 상급종합병원 외래 본인부담률 인상이 당뇨 환자의 외래 의료이용에 미치는 영향

  10. [thesis] 박혜경 / 2011 / 상급종합병원 외래 본인부담률 인상이 외래의료이용에 미치는 영향 : 감기와 고혈압을 중심으로

  11. [jounal] 배지영 / 2010 / 건강보험 보장성 확대가 의료이용 및 건강수준에 미치는 영향 / 사회복지연구 41 (2) : 35 ~ 65

  12. [jounal] 이상영 / 2003 / 의료기관종별수가차등제 도입시 의료기간 수익과 국민의료비에 미치는 영향분석 / 보건사회연구 24 (2) : 157 ~ 180

  13. [confproc] 이상영 / 2010 / 의료기관 종별 기능정립방안 / 보건복지포럼

  14. [book] 채유미 / 2003 / 의료전달체계의 개선방향 :의료제도발전을 위한 정책과제자료집 / 의료정책연구소

  15. [report] 한국보건산업진흥원 / 2001 / 보건의료발전계획 수립을 위한 기초연구

  16. [jounal] 한달선 / 1991 / 보험진료체계 개편의 효과에 대한 연구 / 예방의학회지 24 (4) : 485 ~ 494

  17. [jounal] 한달선 / 2010 / 의료전달체계에 관한 정책의제의 재조명 / 보건행정학회지 20 (4) : 1 ~ 18

  18. [report] Chandra A / 2007 / Patient cost-sharing, hospitalization offsets, and the design of optimal health insurance for the elderly

  19. [jounal] Evans RG / 1995 / User Fees for Health Care: Why a Bad Idea Keeps Coming Back (Or, What’s Health Got to Do With It?) / Canadian Journal on Aging 14 (2) : 360 ~ 390

  20. [jounal] Hartung DM / 2008 / Impact of a Medicaid copayment policy on prescription drug and health services utilization in a fee-for-service Medicaid population / Med Care 46 : 565 ~ 572

  21. [jounal] Heisler M. / 2004 / The health effects of restricting prescription medication use because of cost / Medical Care 42 (7) : 626 ~ 634

  22. [jounal] Kan M. / 2010 / Effects of cost sharing on the demand for physician services in Japan: Evidence from a natural experiment / Japan and the World Economy 22 (1) : 1 ~ 12

  23. [jounal] Kim J / 2005 / The effects of patient cost sharing on ambulatory utilization in South Korea / Health Policy 72 (3) : 293 ~ 300

  24. [jounal] Ligon JA. / 1993 / The effect of health insurance cost sharing within episodes of medical care / J Risk Insurance 60 (1) : 105 ~ 118

  25. [jounal] Manning W. / 1996 / Health insurance: the tradeoff between risk pooling and moral hazard / Journal of Health Economics 15 : 609 ~ 639

  26. [report] O'Sullivan E. / 2008 / Research Methods for Public Administration

  27. [jounal] Rasell lME / 1995 / Cost sharing in health insurance: a re-examination / N Engl J Med 332 : 1164 ~ 1168

  28. [jounal] Selby JV / 1997 / Cost sharing in the emergency department / N Engl J Med 336 : 1750 ~ 1751

  29. [jounal] Shapiro MF / 1989 / Out-of-pocket payment and use of care for serious and minor symptoms: results of a national survey / Arch Intern Med 149 : 1645 ~ 1648

  30. [jounal] Skriabikova O. / 2010 / Empirical Models of Demand for Out-Patient Physician Serivcies and their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature / International Journal of Environmental Research and Public Health 7 : 2708 ~ 2725

  31. [jounal] Trivedi AN / 2010 / Increased Ambulatory Care Copayments and Hospitalizations among the Elderly / The New England Journal of Medicine 362 : 320 ~ 328