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- Effects of the Out-of-pocket Payment Exemption in the Public Health Center on Medical Utilization of the Korean Elderly
- Kiryong Nam, Eunhye Park, Yuhjin Chung, Chang-yup Kim
- J Prev Med Public Health. 2020;53(6):455-464. Published online October 20, 2020
- DOI: https://doi.org/10.3961/jpmph.20.341
- 3,090 View
- 130 Download
- 1 Crossref
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Abstract
PDF - Objectives
The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals.
Methods
This study used online data on Korean national law to gather information on individual local governments’ regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources.
Results
The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48).
Conclusions
The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea. -
Summary
Citations
Citations to this article as recorded by
- Access of older people to primary health care in low and middle-income countries: A systematic scoping review
Saydeh Dableh, Kate Frazer, Diarmuid Stokes, Thilo Kroll, Dirceu Henrique Paulo Mabunda
PLOS ONE.2024; 19(4): e0298973. CrossRef
- Association Between Local Government Social Expenditures and Mortality Levels in Korea
- Hansoo Ko, Jinseob Kim, Donggil Kim, Saerom Kim, Yukyung Park, Chang-yup Kim
- J Prev Med Public Health. 2013;46(1):1-9. Published online January 31, 2013
- DOI: https://doi.org/10.3961/jpmph.2013.46.1.1
- 8,353 View
- 72 Download
- 2 Crossref
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Abstract
PDF
Objectives We examined the association between social expenditures of the local government and the mortality level in Korea, 2004 to 2010.
Methods We used social expenditure data of 230 local governments during 2004 to 2010 from the Social Expenditure Database prepared by the Korean Institute for Health and Social Affairs. Fixed effect panel data regression analysis was adopted to look for associations between social expenditures and age-standardized mortality and the premature death index.
Results Social expenditures of local governments per capita was not significantly associated with standardized mortality but was associated with the premature death index (decline of 1.0 [for males] and 0.5 [for females] for each expenditure of 100 000 Korean won, i.e., approximately 100 US dollar). As an index of the voluntary effort of local governments, the self-managed project ratio was associated with a decline in the standardized mortality in females (decline of 0.4 for each increase of 1%). The share of health care was not significant.
Conclusions There were associations between social expenditures of the local government and the mortality level in Korea. In particular, social expenditures per capita were significantly associated with a decline in premature death. However, the voluntary efforts of local governments were not significantly related to the decline in premature death.
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Summary
Citations
Citations to this article as recorded by- Public health management: systemic analysis of social determinants of health in Brazilian municipalities
Francisco Carlos Carvalho de Melo, Rodolfo Ferreira Ribeiro da Costa, Jansen Maia Del Corso
Health Policy and Planning.2020; 35(2): 123. CrossRef - The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey
Hye Ah Lee, Hyejin Han, Seonhwa Lee, Bomi Park, Bo Hyun Park, Won Kyung Lee, Ju Ok Park, Sungok Hong, Young Taek Kim, Hyesook Park
BMC Public Health.2018;[Epub] CrossRef
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