Browse > Article
http://dx.doi.org/10.4332/KJHPA.2021.31.2.173

Factors Affecting the Length of Stay of Long-Stay Medical Aid Inpatients in Korea: Focused on Hospitalization Types in Long-Term Care Hospitals  

Yun, Eun Ji (Review and Assessment Research Department, Health Insurance Review and Assessment Service)
Lee, Yo Seb (Review and Assessment Research Department, Health Insurance Review and Assessment Service)
Hong, Mi Yeong (Health Benefits System Research Department, Health Insurance Review and Assessment Service)
Park, Mi Sook (Medical Fee Schedule Department, Health Insurance Review and Assessment Service)
Publication Information
Health Policy and Management / v.31, no.2, 2021 , pp. 173-179 More about this Journal
Abstract
Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.
Keywords
Long-stay inpatients; Medical aid; Length of stay; Long-term care hospitals;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Hwang DK, Kim TW, Park GR, Yeo NG. Investigation of long-term hospitalization recipients and a study on the appropriate payment plan for livelihood aids. Sejong: Korea Institute for Health and Social Affairs; 2016.
2 Ministry of Health and Welfare; Ministry of Land, Infrastructure and Transport; Ministry of Education. The 1st basic living security comprehensive plan (2018-2020) [Internet]. Sejong: Ministry of Health and Welfare; 2017 [cited 2020 Sep 1]. Available from: http://www.mohw.go.kr/upload/viewer/skin/doc.html?fn=1502341975950_20170810141256.pdf&rs=/upload/viewer/result/202106/.
3 National Health Insurance Service. 2018 Medical aid statistics. Wonju: National Health Insurance Service; 2018.
4 Son CW. Health management and medical use of medical aids recipients in Seoul. Policy Rep (Seoul Inst) 2018;(253):1-23.
5 Lee YJ. Medical care utilization between national health insurance and medical assistance in elderly patients. J Korea Contents Assoc 2017;17(4):585-595. DOI: https://doi.org/10.5392/JKCA.2017.17.04.585.   DOI
6 Kim ES, Nam JJ, Kim MY, Ko IS, Lee DK, Kim GS. The status and improvement of medical use of long-term patients with medical aids. Seoul: Yonsei University College of Nursing, Nursing Policy Research Institute; 2007.
7 Yoo AJ, Moon YP, Lee HY, Lee HS, Park YW. Long-term care blind spot diagnosis and tasks: focusing on eligible people and benefits. Wonju: National Health Insurance Service; 2019.
8 Lim JS, Yoo WS, Lee HJ, Jeon GJ, Lim SJ, Kim CH, et al. A study on the selection of effective case management targets for financial reduction of medical aids [Internet]. Daejeon: Eulji University; 2011 [cited 2020 Sep 1]. Available from: http://www.nl.go.kr/app/nl/search/common/download.jsp?file_id=FILE-00008151641.
9 Ministry of Health and Welfare. Integrated care for local communities (community) leading project promotion plan. Sejong: Ministry of Health and Welfare; 2019.
10 Jeon B, Kim H, Kwon S. Patient and hospital characteristics of long-stay admissions in long-term care hospitals in Korea. Health Policy Manag 2016;26(1):39-50. DOI: https://doi.org/10.4332/KJHPA.2016.26.1.39.   DOI
11 NHS England; NHS improvement. A manager's guide to criteria-led discharge. London: NHS Improvement; 2019.
12 Ministry of Health and Welfare. Provides health care services for each target by utilizing big data [Internet]. Sejong: Ministry of Health and Welfare; 2019 [cited 2020 Dec 10]. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=349609.
13 Hwang DK, Shin HW, Yeo JY, Kim JH, Lee SG, Seong MH. A study on the status of medical use of oversized users. Sejong: Korea Institute for Health and Social Affairs; 2014.
14 E-Country Indicators. National basic livelihood security supply and demand status [Internet]. Daejeon: Statistics Korea; 2020 [cited 2020 Sep 1]. Available from: http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=2760.
15 Hwang DK, Lee SY, Kim DE, Yeo NG, Choi JH, Kim JH, et al. Investigation on the actual condition of long-term hospitalization of medical aids recipients and a study on management plans. Sejong: Korea Institute for Health and Social Affairs; 2015.
16 Ministry of Health and Welfare. 2020 Medical aids business guide. Sejong: Ministry of Health and Welfare; 2020.
17 NHS Improvement. Guide to reducing long hospital stays. London: NHS Improvement; 2018.
18 Shin HW, Yoon JH, Lee CS, Lim JW, Hwang SM. Analysis and improvement measures for medical care provider treatment. Sejong: Korea Institute for Health and Social Affairs; 2012.