Success of case management for medical aid initiative in Korea

The purpose of this cross-sectional study was to determine the effects of case management of Korea Medical Aid on recipients' satisfaction, ability to handle health problems, health behaviour, quality of life (QoL), hospital visiting days and medical expenditure. Data from structured interviews and claim data from medical institutions to the Korea National Health Insurance Corporation were used. Survey data were collected by questionnaire during September 2008. There were 647 responses out of 1069 (response rate 60.5%), but 260 were excluded from the analyses in this paper because they had received case management for <18 months. This left 269 individuals who had received case management services for 18 months continuously and 118 who had received no case management services in the same time period. Among the former group, 86.9% were satisfied or strongly satisfied with the initiative. Results indicate that the satisfaction for the case management was very high. Although there was no difference in terms of health behaviour and QoL between the two groups, the overall ability to handle health problems was higher in the case management group (P < 0.001). As for healthcare use, the programme produced a significant reduction in hospital visiting days (P = 0.034), and while the mean increase in cost from 2007 to 2008 was 29.1% lower for individuals in the programme, the difference between the groups was not significant (P = 0.851). Case management in Korea is in its early stages, and efforts should be made to extend this approach.