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http://dx.doi.org/10.12811/kshsm.2020.14.1.147

Status and Characteristics of Applying a Copayment Ceiling for the Elderly  

Park, Cho-Yeal (Graduate School of Catholic University of Pusan)
Park, Young-Hee (Department of HCM Catholic University of Pusan)
Publication Information
The Korean Journal of Health Service Management / v.14, no.1, 2020 , pp. 147-159 More about this Journal
Abstract
Objectives: This study is the human factors and disease factors of the copayment system for the elderly (>65 years old) and to identify does the current status and characteristics of the applied elderly and conducted to provide basic data. Methods: Sample cohort data from the National Health Insurance Corporation database, from the years 2012-2015, were analyzed of 21,772 elderly people over the copayment ceiling. Results: The ratio of those who exceeded the copayment ceiling system rose sharply from progressive rates of 3.39% in 2012, 3.69% in 2013 and 5.03% in 2014, to rates of 37.13% from 2013. Factors identified that affect the instances of being over the copayment ceiling were: age, income group, region, severity, disability, sickness distribution, inpatient days, and outpatient days. Conclusions: The reorganization of the copayment ceiling system in 2014 favored low-income families of the elderly, but in 2015, the proportion of elderly was low (only 5.78%). The government's policies needs to change to allow for the amount of the deductible upper limit for low- and middle- income groups to be further subdivided in order for the elderly to receive more deductibles.
Keywords
Copayment Ceiling System; Retirees; Elderly; National Health; Insurance Corporation Big data;
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Times Cited By KSCI : 2  (Citation Analysis)
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