Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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The Medical Use of the Disabled Among Overusers of Medical Aid in Korea

의료급여 과다 이용 수급권자 중 장애인의 의료이용

  • Shin, Sun-Mi (Office of Global Health Leadership, University of Illinois at Chicago) ;
  • Kim, Eui-Sook (Korea Human Resource Development Institute for Health and Welfare, Institute of Case Management) ;
  • Park, Chang-Ki (Office of Global Health Leadership, University of Illinois at Chicago) ;
  • Lee, Hee-Woo (Seoul Education Research Information Institute)
  • 신선미 (일리노이주립대학교 국제보건리더쉽센터) ;
  • 김의숙 (한국보건복지인력개발원 의료급여사례관리사업지원단) ;
  • 박창기 (일리노이주립대학교 국제보건리더쉽센터) ;
  • 이희우 (서울특별시교육연구정보원)
  • Published : 2010.01.31
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Abstract

Objectives: In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. Methods: Subjects (n=2,211) selected were ${\geq}18$-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. Results: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(￦), inpatient payment of ￦359,000, and outpatient payment of ￦183,000. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (￦82,000), elementary school or lower educational level (￦64,000), residence in a small city (￦82,000), lack of family support (￦61,000), kidney disability (￦673,000), intellectual disability (￦151,000), and multiple disabilities (￦119,000). Conclusions: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.

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