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Differential cost-sharing and utilization of outpatients care by types of medical institutions

Jinok Byeon 1 Haryeom Ghang 2 Hyunboc, Lee 1

1국민건강보험공단 정책연구원
2국민건강보험공단

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ABSTRACT

This study addressed two differential cost-sharing polices in July 2009 and October2011 to check whether outpatients were affected by the policies in using healthcare services and to draw out implications for establishing more efficient medicalcare delivery system by easing the tendency towards big hospitals. In 2009, theco-payment rate for outpatients at tertiary care hospital was increased. In 2011, theco-payment rate for pharmaceutical services were increased when people get drugprescriptions at general hospital and tertiary care hospital for treating 52 specificdiseases. The study result showed that ‘time-after 2009 policy’, ‘the implementation of 2011policy’, and ‘time-after 2011 policy’ factors had impacts on reducing the number ofoutpatients and the amount of outpatients’medical expenses in tertiary carehospital. However, these policies were not appeared to be effective in increasingthe numbers of outpatients and the amount of medical expanses in clinics andhospitals. Based on this study, it’s not clear that decreased utilization of tertiary care hospitaland general hospital through co-payment polices has been converted to demandfor the small hospitals and clinics. These results imply that price policy such as differential cost-sharing intended to alter behaviors of demand side of health careservice has limited effect on functionalizing the level of medical institutions. Important implications for Korea from the study are two-folds. First, what we needmay not be the government’s leading role in increasing part-time work opportunitiesfor most women, but rather, common efforts by workers and employers togetherwith the entire society in deciding the future direction of the society modelwe want to pursue in the long run. Moreover, what types of roles women will beexpected to play in the future Korean society must also be decided upon. Therefore, not only labour policies, but also women, family, and welfare policiesshould be considered all together in harmony.

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* References for papers published after 2023 are currently being built.