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Original Article
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
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AbstractAbstract 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

JPMPH : Journal of Preventive Medicine and Public Health