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Impact of Coinsurance Reduction Policy on Healthcare Utilization Among Children Under 15
Minah Park1,2, Eun-Cheol Park1,3, Hongin Noh4
1Institute of Health Services Research, Yonsei University, Seoul, Korea.
Insights
A 2017 policy reduced coinsurance for children under 15, increasing inpatient care and decreasing outpatient visits for 1-5-year-olds. The policy’s impact on older children’s healthcare utilization was inconclusive.
Area of Science:
- Health Services Research
- Pediatric Health Policy
- Healthcare Economics
Background:
- A 2017 policy aimed to improve children's access to inpatient medical services by reducing coinsurance rates for those under 15.
- The policy sought to address economic barriers to accessing necessary pediatric healthcare.
Purpose of the Study:
- To evaluate the impact of a coinsurance reduction policy on healthcare utilization among children.
- To analyze changes in inpatient and outpatient service utilization following the policy implementation.
Main Methods:
- Utilized data from the National Health Insurance Service-National Sample Cohort (2015-2019).
- Employed a difference-in-differences method to compare healthcare utilization changes.
- Analyzed inpatient costs, admissions, length of stay, outpatient costs, and visits, stratified by age groups.
Main Results:
- Children aged 1-5 showed a significant increase in inpatient utilization (16.17% cost, 8.55% admission, 10.67% length of stay) and a decrease in outpatient utilization (-9.14% cost, -6.79% visits).
- A substitution effect between inpatient and outpatient services was observed in the 1-5 age group.
- The policy's effect on healthcare utilization for children aged 6-15 was inconclusive.
Conclusions:
- The coinsurance reduction policy effectively increased inpatient service use and decreased outpatient service use among young children (1-5 years), indicating a substitution effect.
- Further research is recommended to investigate the long-term consequences of this healthcare policy on pediatric utilization patterns.
Background:
On October 1, 2017, a new coinsurance reduction policy for children under 15 was introduced to minimize the lack of inpatient medical services for economic reasons and secure children's access to medical care.
Methods:
This study analyzes the effect of this coinsurance reduction policy on healthcare utilization using data from the National Health Insurance Service-National Sample Cohort between 2015 and 2019. Groups were classified by 3 case groups and a control group according to age. The dependent variables were inpatient cost, admission, length of hospitalization, outpatient cost and visit, and total cost. The difference-in-differences method was used to examine changes in healthcare utilization among the case and control groups after policy implementation.
Results:
Children of the age group 1-5 exhibited an increase in inpatient services and a decrease in outpatient services. There was a 16.17% increase in inpatient cost, 8.55% increase in inpatient admission, 10.67% increase in inpatient length of hospitalization, -9.14% decline in outpatient cost, and -6.79% decline in outpatient visits. Regarding children in the age groups of 6-10 and 11-15, the effect of the policy was inconclusive.
Conclusion:
The reduction in coinsurance rate policy in hospitalization among children has increased inpatient services and reduced outpatient services for 1-5-year-olds-a substitute effect was observed in this group. There is need for further research to examine the long-term effects of the coinsurance reduction policy.
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