노인외래정액제 개선이 고령층의 의료이용에 미친 영향 = The Effects of the Revised Elderly Fixed Outpatient Copayment on the Health Utilization of the Elderly

다국어 초록 (Multilingual Abstract)

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years andolder receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expensesexceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed toexamine the changes of health utilization of elderly after revised elderly fixed outpatient copayment.
Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixedoutpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilizationand conducted segmented regression to estimate the changes in medical expenses.
Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarilydecreased but increased again.
Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. Anda temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run,efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.