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The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul

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  • Jungah Kim

    (The Seoul Institute, 57 Nambusunhwan-ro, 340-gil, Seocho-gu, Seoul 06756, Korea)

  • Changwoo Shon

    (The Seoul Institute, 57 Nambusunhwan-ro, 340-gil, Seocho-gu, Seoul 06756, Korea)

Abstract

The Medical Aid program is government’s medical benefit program to secure the minimum livelihood and medical services for low-income Korean households. In Seoul, the number of Medical Aid beneficiaries has grown, driving an increases in the length of stay (LOS) and healthcare cost. Until now, studies have focused on quantity indicators, such as LOS, but only a few studies have been conducted on the service quality. We investigated both LOS and the preventable hospitalization (PH) rate as proxy indicators for the quantity and quality of services provided to Medical Aid beneficiaries in Seoul. To understand the program’s impact, we extracted appropriate data of Medical Aid beneficiaries and data of the lower 20% of National Health Insurance (NHI) enrollees, performed Propensity Score Matching (PSM), and controlled the variables related to disease severity. The differences between Medical Aid beneficiaries and NHI enrollees were estimated using multilevel analysis. The LOS of Medical Aid beneficiaries was longer, and the preventable hospitalization (PH) rate was higher than that of NHI enrollees. It implies that these beneficiaries did not receive timely and adequate healthcare services, despite their high rate of service utilization. Thus, indicators such as patient’s visits and screening related to PHs should be included in management policies to improve primary care.

Suggested Citation

  • Jungah Kim & Changwoo Shon, 2018. "The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul," IJERPH, MDPI, vol. 15(4), pages 1-11, April.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:772-:d:141421
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    References listed on IDEAS

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    1. Pappas, G. & Hadden, W.C. & Kozak, L.J. & Fisher, G.F., 1997. "Potentially avoidable hospitalizations: Inequalities in rates between US socioeconomic groups," American Journal of Public Health, American Public Health Association, vol. 87(5), pages 811-816.
    2. Nak-Jin Sung & Yong-Jun Choi & Jae-Ho Lee, 2018. "Primary Care Comprehensiveness Can Reduce Emergency Department Visits and Hospitalization in People with Hypertension in South Korea," IJERPH, MDPI, vol. 15(2), pages 1-11, February.
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    Cited by:

    1. Jeonghyun Cho & Kyungin Jeong & Samsook Kim & Hyejin Kim, 2019. "Exploring the Healthcare Seeking Behavior of Medical Aid Beneficiaries Who Overutilize Healthcare Services: A Qualitative Descriptive Study," IJERPH, MDPI, vol. 16(14), pages 1-9, July.
    2. Myung Ja Kim & Eunhee Lee, 2020. "How to Reduce Excessive Use of the Health Care Service in Medical Aid Beneficiaries: Effectiveness of Community-Based Case Management," IJERPH, MDPI, vol. 17(7), pages 1-10, April.

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