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Impact of health insurance status changes on healthcare utilisation patterns: a longitudinal cohort study in South
Jae-Hyun Kim1, Sang Gyu Lee2, Kwang-Soo Lee3
1Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
Objectives:
The study examined medical care utilisation by health insurance status changes.
Setting:
The Korean Welfare Panel Study (KoWePs) was used.
Participants:
This study analysed 14,267 participants at baseline (2006).
Interventions:
The individuals were categorised into four health insurance status groups: continuous health insurance, change from health insurance to Medical Aid, change from Medical Aid to health insurance, or continuous Medical Aid.
Primary And Secondary Outcome Measures:
Three dependent variables were also analysed: days spent in hospital; number of outpatient visits; and hospitalisations per year. Longitudinal data analysis was used to determine whether changes in health insurance status were associated with healthcare utilisation.
Results:
The number of outpatient visits per year was 0.1.363 times higher (p<0.0001) in the continuous Medical Aid than in the continuous health insurance group. The number of hospitalisations per year was 1.560 times higher (p<0.001) in new Medical Aid and -0.636 times lower (p<0.001) in new health insurance than in continuous health insurance group. The number of days spent in hospital per year was -0.567 times lower (p=0.021) in the new health insurance than in the continuous health insurance group.
Conclusions:
Health insurance beneficiaries with a coverage level lower than Medical Aid showed lower healthcare utilisation, as measured by the number of hospitalisations and days spent in hospital per year.
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