Impact of a diagnosis-related group payment system on cesarean section in Korea

Seung Ju Kim, Kyu Tae Han, Sun Jung Kim, Euncheol Park, Hye Ki Park

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Cesarean sections (CSs) are the most expensive method of delivery, which may affect the physician's choice of treatment when providing health services to patients. We investigated the effects of the diagnosis-related group (DRG)-based payment system on CSs in Korea. We used National Health Insurance claim data from 2011 to 2014, which included 1,289,989 delivery cases at 674 hospitals. We used a generalized estimating equation model to evaluate the association between the likelihood of cesarean delivery and the length of the DRG adoption period. A total of 477,309 (37.0%) delivery cases were performed by CSs. We found that a longer DRG adoption period was associated with a lower odds ratio of CSs (odds ratio [OR]: 0.997, 95% CI: 0.996-0.998). In addition, a longer DRG adoption period was associated with a lower odds ratio for CSs in hospitals that had voluntarily adopted the DRG system. Similar results were also observed for urban hospitals, primiparas, and those under 28 years old and over 33 years old. Our results suggest that the change in the reimbursement system was associated with a low likelihood of CSs. The impact of DRG adoption on cesarean delivery can also be expected to increase with time, as our finding provides evidence that the reimbursement system is associated with the health provider's decision to provide health services for patients.

Original languageEnglish
Pages (from-to)596-603
Number of pages8
JournalHealth Policy
Volume120
Issue number6
DOIs
Publication statusPublished - 2016 Jun 1

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Diagnosis-Related Groups
Korea
Cesarean Section
Odds Ratio
Health Services
Urban Hospitals
National Health Programs
Physicians
Health

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Kim, Seung Ju ; Han, Kyu Tae ; Kim, Sun Jung ; Park, Euncheol ; Park, Hye Ki. / Impact of a diagnosis-related group payment system on cesarean section in Korea. In: Health Policy. 2016 ; Vol. 120, No. 6. pp. 596-603.
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Impact of a diagnosis-related group payment system on cesarean section in Korea. / Kim, Seung Ju; Han, Kyu Tae; Kim, Sun Jung; Park, Euncheol; Park, Hye Ki.

In: Health Policy, Vol. 120, No. 6, 01.06.2016, p. 596-603.

Research output: Contribution to journalArticle

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