Effect of health insurance type on health care utilization in patients with hypertension: A national health insurance database study in Korea

Hae Sun Suh, Hye Young Kang, Jinkyung Kim, Euichul Shin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Higher utilization of healthcare services has been observed among individuals who receive public aid compared to individuals who do not receive public aid in many countries. However, no systematic investigations have explored whether this pattern of higher utilization persists after correcting for a number of factors in Korea. In this study, we sought to examine whether the type of health insurance, wage-based contributory insurance (Health Insurance, HI) or government-subsidized public assistance (Medical Aid, MA), affects the utilization of inpatient services after controlling for baseline patient and institutional characteristics among patients with hypertension in Korea. Methods: The Korean National Health Insurance claims database from 2006 and 2007 was used for analysis. To avoid biased estimates, we determined the most appropriate type of multivariate model for each outcome variable: a logistic regression model for the likelihood of hospitalization, a zero-inflated negative binomial model for the length of stay (LOS), and a generalized linear model with a log-link function for hospitalization costs. Results: Adjusted odds ratio (OR) and factor changes showed that MA patients (n = 21,539) had a significantly higher likelihood of hospitalization (OR: 1.41-1.71), average LOS per patient (factor change: 1.31-1.42), and hospitalization costs per patient (factor change: 1.10-1.41) compared to HI patients (n = 304,027). Conclusions: The pattern of higher healthcare utilization among MA patients persists even after controlling for baseline health conditions. This finding confirms that the type of health insurance affects the utilization of healthcare resources, and suggests that effective strategies are necessary to prevent the potential overutilization of inpatient care by MA patients with hypertension in Korea.

Original languageEnglish
Article number570
JournalBMC Health Services Research
Volume14
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

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Patient Acceptance of Health Care
National Health Programs
Health Insurance
Korea
Databases
Hypertension
Hospitalization
Delivery of Health Care
Inpatients
Length of Stay
Logistic Models
Public Assistance
Odds Ratio
Costs and Cost Analysis
Salaries and Fringe Benefits
Statistical Models
Insurance
Linear Models

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

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abstract = "Background: Higher utilization of healthcare services has been observed among individuals who receive public aid compared to individuals who do not receive public aid in many countries. However, no systematic investigations have explored whether this pattern of higher utilization persists after correcting for a number of factors in Korea. In this study, we sought to examine whether the type of health insurance, wage-based contributory insurance (Health Insurance, HI) or government-subsidized public assistance (Medical Aid, MA), affects the utilization of inpatient services after controlling for baseline patient and institutional characteristics among patients with hypertension in Korea. Methods: The Korean National Health Insurance claims database from 2006 and 2007 was used for analysis. To avoid biased estimates, we determined the most appropriate type of multivariate model for each outcome variable: a logistic regression model for the likelihood of hospitalization, a zero-inflated negative binomial model for the length of stay (LOS), and a generalized linear model with a log-link function for hospitalization costs. Results: Adjusted odds ratio (OR) and factor changes showed that MA patients (n = 21,539) had a significantly higher likelihood of hospitalization (OR: 1.41-1.71), average LOS per patient (factor change: 1.31-1.42), and hospitalization costs per patient (factor change: 1.10-1.41) compared to HI patients (n = 304,027). Conclusions: The pattern of higher healthcare utilization among MA patients persists even after controlling for baseline health conditions. This finding confirms that the type of health insurance affects the utilization of healthcare resources, and suggests that effective strategies are necessary to prevent the potential overutilization of inpatient care by MA patients with hypertension in Korea.",
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Effect of health insurance type on health care utilization in patients with hypertension : A national health insurance database study in Korea. / Suh, Hae Sun; Kang, Hye Young; Kim, Jinkyung; Shin, Euichul.

In: BMC Health Services Research, Vol. 14, No. 1, 570, 01.01.2014.

Research output: Contribution to journalArticle

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