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Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center  

Lim, Jin-Hwa (National Cancer Control Research Institute, National Cancer Center)
Choi, Kui-Son (National Cancer Control Research Institute, National Cancer Center)
Kim, Sung-Gyeong (National Cancer Control Research Institute, National Cancer Center)
Park, Eun-Cheol (National Cancer Control Research Institute, National Cancer Center)
Park, Jae-Hyun (National Cancer Control Research Institute, National Cancer Center)
Publication Information
Journal of Preventive Medicine and Public Health / v.40, no.4, 2007 , pp. 329-335 More about this Journal
Abstract
Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.
Keywords
Insurance; Neoplasms; Moral hazard; Health expenditures;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
Times Cited By SCOPUS : 4
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1 Korea National Statistical Office. Death registry data. Korea National Statistical Office; 2006 [cited 2007 March 7]. Available from: URL http://www.nso.go.kr/nso2006/k04_0000/k04g_0000/k04gb_0000/k04gbc0000/k04gbc0080/k04gbc0080.html (Korean)
2 Cartwright W, Hu T, Huang L. Impact of varying Medigap insurance coverage on the use of medical services of the elderly. Appl Econ 1992; 24(5): 529-539   DOI   ScienceOn
3 Buchmuellera T, Couffinhalb A, Grignonb M, Perronninb M. Access to physician service: does supplemental insurance matter? Evidence from France. Health Econ 2004; 13(7): 669-687   DOI   ScienceOn
4 Kang SW, Kwon YD, Kim SA. Effects of private health insurance on hospitals in Korea. Korean J Health Econs Policy 2004; 10(2): 23- 36 (Korean)
5 Yoon TH, Hwang IK, Sohn HS, Koh KW, Jeong BG. The determinants of private health insurance purchasing decisions under national health insurance system in Korea : The expanding of private health insurance market, for the better or worse. Korean J Health Policy Admin 2005; 15(4): 161-175 (Korean)   DOI
6 Ministry of Health & Welfare. Cancer Incidence in Korea 1999-2001. Ministry of Health & Welfare; 2006 [cited 2007 March 11]. Available from: URL: http://www.cancer.go.kr/ nciapps/user/stat/view .jsp ?seq=33&sta_ base year=&sta_gubun=¤tPage=2&sValue=&cancer_cmd=ALLNANNANNAN&sChk=&ke yword=&tmp_keyword=&sCatgType 1=(Korean)
7 Park HM, Kim KH. Expanding the Role of Private Health Insurance in Health Insurance. Seoul: Korea Insurance Development Institute; 2001. p. 59-61 (Korean)
8 Lee JS. Privatization of health service and health insurance. Health insur forum 2005; 4(1): 5-16 (Korean)
9 Manning WG, Newhouse JP, Duan N, Keeler EB, Leibowitz A, Marquis MS. Health insurance and the demand for medical care: Evidence from a randomized experiment. Am Econ Rev 1987; 77(3): 251-277   PUBMED
10 Choi BH. Healthcare market opening and private health insurance. Policy Forum 2004; 88: 29-41 (Korean)
11 Hurd MD, McGarry K Medical insurance and the use of health care services by the elderly. J Heolth Econ 1997; 16(2): 129-154   DOI   ScienceOn
12 National Health Insurance Coporation. [cited 2007 March 4]. Available from: URL: http://www.nhic.or.kr/wbm/wbmc/wbmc_0400/wbmc_0401/wbmc_0401.html
13 Wolfe J, Goddeeris J. Averse selection, moral hazard, and wealth effects in the Medigap insurance market. J Health Econ 1991; 10(4): 433459
14 Jung KT, Shin EK, Kwak CH. An Empirical study on the relationship between private health insurance and moral hazard. Korean Insur J 2006; 75: 1-25 (Korean)
15 Long SH, Marquis MS. The uninsured 'access gap' and the cost of universal coverage. Health Aff(Millwood) 1994; 13(2): 211-220   DOI   ScienceOn
16 Oh YS. A Study on new relationship between national and private health insurance. J Insur Stud 2006; 17(1): 103-136 (Korean)
17 건보 재정흑자, 저소득 암환자에 써라. 한국일보 2005년 4월 27일자 [cited 2007 May 27] Available from: URL:http://news.hankooki . com/lpage/society/200504/h2005042718194621950.htm
18 OECD. Private health insurance in OECD countries. Paris: OECD Publishing; 2004. p. 35-37
19 Jung KT. Trends of Private Health Insurance Market and Related Policy Issues. Seoul: Property Insurance; 2005: p. 7-17 (Korean)
20 Schellhorn M. The effect of variable health insurance deductibles on the demand for physician visits. Health Econ 2001; 10(5): 441-456   DOI   PUBMED   ScienceOn
21 Hanmon C, Nolan B. Health insurance and health services utilization in Ireland. Health Econ 2001; 10(2): 135-145   DOI   ScienceOn
22 Joung KT. Private health insurance development strategy.lnsur dev 1996; 17: 127-149 (Korean)
23 Yang BM. Health Economics. Seoul: Nanam Pub. Co; 1999.p.145-146(Korean)
24 Kim WS. Balanced development of national health insurance and private health insurance. lnsur dev 2002; 13(3): 111-153 (Korean)
25 Vera-Hernandez AM. Duplicate coverage and demand for health care. The case of Catalonia. Health Econ 1999; 8(7): 579-598   DOI   ScienceOn
26 Ettner S. Adverse selection, the purchase of medigap insurance by the elderly. J Health Econ 1997; 16(5): 543-562   DOI   PUBMED   ScienceOn
27 Kang SW, Kwon YD, You CH. Effects of supplemental insurance on health care utilization and expenditures among cancer patients in Korea. Korean J Health Policy Admin 2005; 15(4): 65-80 (Korean)   DOI
28 Atherly A. The effect of medicare supplemental insurance on medicare expenditures.lnt J Health Care Finance Econ 2002; 2(2): 137-162   DOI   PUBMED   ScienceOn
29 Sapelli C, Vial B. Self-selection and moral hazard in Chilean health insurance. J Health Econ 2003; 22(3): 459-476   DOI   ScienceOn
30 Kim WJ. Introduction of private health insurance and related issues. Korean Health assoc 2004; 33(1): 66-74 (Korean)
31 Lim JH, Kim SG, Lee EM, Bae SY, Park JH, Choi KS, Hahm MI, Park EC. The determinants of purchasing private health insurance in Korean cancer patients. J Prev Med Public Health 2007; 40(2): 150-154 (Korean)   과학기술학회마을   DOI   ScienceOn
32 Kim SO. Risk Selection of Private Health Insurance and Medical Care Utilization. Seoul: The 6th Korea Labor Panel Journal; 2005. p. 2131 (Korean)
33 Korea Insurance Development Institute. Risk Management of Private Health Insurance, CEO Report. Seoul: Korea Insurance Development Institute; 2005. p. 1-2 (Korean)
34 Gam S. Influence of Health care market liberalization on health insurance structure. Health insur forum 2005; 4(1): 17-30 (Korean)