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http://dx.doi.org/10.3961/jpmph.2010.43.6.496

The Effect of Outpatient Cost Sharing on Health Care Utilization of the Elderly  

Kim, Myung-Hwa (Health Insurance Review & Assessment Service)
Kwon, Soon-Man (The Graduate School of Public Health, Seoul National University)
Publication Information
Journal of Preventive Medicine and Public Health / v.43, no.6, 2010 , pp. 496-504 More about this Journal
Abstract
Objectives: The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly. Methods: The data in this analysis was the health insurance claims data between July 1999 and December 2008 (114 months). The study group was divided into two age groups, namely 60-64 years old and 65-69 years old. This study evaluated the impact of policy change on office visits, the office visits per person, and the percentage of the copayment-paid visits in total visits. Interrupted time series and segmented regression model were used for statistical analysis. Results: The results showed that outpatient cost-sharing decreased office visits, but it also decreased the percentage of copayment-paid visits, implying that the intensity of care increased. There was little difference in the results between the two age groups. But after the introduction of the coinsurance system for those patients under age 65, office visits and the percentage of copayment-paid visits decreased, and the 60-64 years old group had a larger decrease than the 65-69 years old group. Conclusions: This study evaluated the effects of outpatient cost-sharing on health care utilization by the aged. Cost sharing of the elderly had little effect on controlling health care utilization.
Keywords
Cost sharing; Aged; Health care; Utilization; Outpatients;
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1 Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Ther 2002; 27(4): 299-309.   DOI   ScienceOn
2 Ku L, Wachino V. The Effect of Increased Cost-Sharing in Medicaid: A Summary of Research Findings. Washington DC: Center on Budget and Policy Priorities; 2005.
3 Gibson TB, Ozminkowski RJ, Goetzel RZ. The effects of prescription drug cost sharing: a review of the evidence. Am J Manag Care 2005; 11(11): 730-740.
4 Goldman DP, Joyce GF, Zheng Y. Prescription drug cost sharing: associations with medication and medical utilization and spending and health. JAMA 2007; 298(1): 61-69.   DOI   ScienceOn
5 Lee HS. A study on factors causing health conditions and the burden of medical expenses to the elderly. J Korea Gerontol Soc 2004; 24(2): 163-179. (Korean)
6 Park CM, Kim DS, Moon KT. A Study of Prescribing Behavior Monitoring on the Digestive Drug. Seoul: Health Insurance Review & Assessment Service; 2007. (Korean)
7 Cho SS, Lee JH. Economic Time Series Analysis Using SAS/ETS. Seoul: Freedom Academy; 1997. (Korean)
8 Ligon JA. The effect of health insurance cost sharing within episodes of medical care. J Risk Insur 1993; 60(1): 105-118.   DOI   ScienceOn
9 Nakatani H, Kondo T. Characteristics of a medical care program for specific diseases in Japan in an era of changing cost-sharing. Health Policy 2003; 64(3): 377-389.   DOI   ScienceOn
10 Liu SZ, Romeis JC. Changes in drug utilization following the outpatient prescription drug cost-sharing program-- evidence from Taiwan's elderly. Health Policy 2004; 68(3): 277-287.   DOI   ScienceOn
11 Li X, Guh D, Lacaille D, Esdaile J, Anis AH. The impact of cost sharing of prescription drug expenditures on health care utilization by the elderly: own- and cross-price elasticities. Health Policy 2007; 82(3): 340-347.   DOI   ScienceOn
12 Briesacher BA, Soumerai SB, Field TS, Fouayzi H, Gurwitz JH. Nursing home residents and enrollment in Medicare Part D. J Am Geriatr Soc 2009; 57(10): 1902-1907.   DOI   ScienceOn
13 Chandra A, Gruber J, McKnight R. Patient cost-sharing, hospitalization offsets, and the design of optimal health insurance for the elderly. Cambridge, MA: NBER Working Paper; 2007.
14 Nelson AA Jr, Reeder CE, Dickson WM. The effect of a Medicaid drug copayment program on the utilization and cost of prescription services. Med Care 1984; 22(8): 724-736.   DOI   ScienceOn
15 Lee YJ. A study on the influences of changes to the copayment of cancer patients of their uses of medical services. J Korean Public Policy 2009; 11(1): 3-25. (Korean)
16 Van de Voorde C, Van Doorslaer E, Schokkaert E. Effects of cost sharing on physician utilization under favourable conditions for supplier-induced demand. Health Econ 2001; 10(5): 457-471.   DOI   ScienceOn
17 Kim SR, Choi JS, Joo JS, Choi MY, Yang JH, Chai JM. The Effect of Office Visit Copayment on Utilization Among Medicaid Beneficiary in South Korea. Seoul: Health Insurance Review & Assessment Service; 2008. (Korean)
18 Park JY, Chai HY. The effects of an increase of outpatient co-insurance rate on the financial status of the National Health Insurance. Korean Insur J 2003; 64: 109-136. (Korean)
19 Jung GT. An analysis of the effect of increases in user prices on health care use and cost : the Korean experience. Korean Soc Secur Stud 1992; 8: 61-113.
20 Jung GT. Medical institution and diagnosis specific analysis of demand for medical care in Korea. Korean Soc Secur Stud 1993; 9: 193-221.
21 Hong SW. The Effects of Copayment on Healthcare Utilization in the Type I Medicaid Beneficiaries [dissertation]. Seoul: Seoul National University; 2009. (Korean)
22 Kim J, Ko S, Yang B. The effects of patients cost sharing on ambulatory utilization in South Korea. Health Policy 2005; 72(3): 293-300.   DOI   ScienceOn
23 Choi WH. The Impact of Inpatient Copayment Waiver on Medical Service Utilization of Children under 6 [dissertation]. Seoul: Seoul National University; 2008. (Korean)
24 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 Adm 2005; 15(4): 65-80. (Korean)   과학기술학회마을   DOI   ScienceOn
25 Kim JH. Implications of the introduction of outpatient coinsurance system. Health Insur Forum 2007; 6(3): 6-19. (Korean)
26 Kwak SY. An Evaluation on the Effect of the Copayment Waiver Policy for Hospitalized Children under the Age of 6 [dissertation]. Seoul: Korea University; 2008. (Korean)
27 Roh SY, Kim JS. The theoretical study of rational policy decision on the National Health Insurance's copayment. J Korean Public Policy 2008; 10(2): 149-174. (Korean)
28 Kim CB, Lee SY. Trends and its policy implications of copayment system on office-based medical care during the last decade in Korea. Korean J Health Policy Adm 2001; 11(4): 1-20. (Korean)