Rare diseases are not so much developed drugs, but they are expensive to treat, and most of them are genetic. As the process of treating them is prolonged for a lifetime, the burden of disease and the economic burden of rare disease patients and their families is overloaded which can eventually lead...
Rare diseases are not so much developed drugs, but they are expensive to treat, and most of them are genetic. As the process of treating them is prolonged for a lifetime, the burden of disease and the economic burden of rare disease patients and their families is overloaded which can eventually lead to the poverty and the decline of the household of the rare disease patient. In order to reduce the burden of rare diseases and to strengthen the role of health insurance as a social safety net, a system of deduction of 10% of co-payment rate was implemented on July 1, 2009. The purpose of this study is to investigate the effects of expanding benefit coverage for rare diseases implemented in 2009 on the medical utilization of rare diseases and the reduction of burden of household medical expenses. The control group, which is not a policy included group, was selected as a liver disease (severe disease) or hypertension (chronic disease), and was divided according to the period of treatment. The analysis used the NHIS DB of the National Health Insurance Service to identify patients' medical use and household income between 2008 and 2010. The association between policy changes and health care utilization(the number of hospital visits, total medical expenses, out-of-pocket payment) and incidence of catastrophic health expenditure(CHE) is evaluated by pre-post assessment applying multiple Difference-in-Difference model adjusting for sex, age, categories of the insured(the employee insured and the self-employed insured), co-morbidity and disability. As a result of the analysis, the policy implementation of expanding benefit coverage policy for Rare Diseases in 2009 was associated with increased the medical use (number of hospital visits) and total medical expenses of the rare diseases group compared with the control group. On the other hand, we did not confirm the effect of the policy associating with better CHE rate, which has been confirmed by the intersection term. Since, The causal effects caused by the increased medical use, the policy have not affected the overburdened medical costs of households with rare diseases. In order to achieve the policy goals of the "Rare Disease Act" and "Rare Disease Comprehensive Management Plan" implemented in 2016 for the management of rare diseases at the national level and to expand the coverage of health insurance coverage to extreme rare diseases, It is necessary to adopt a policy to extend the whole coverage like the “Catastrophic healthcare expenses support policy” which has the possibility of reducing the medical burden of the household and reducing the burden of the medical expenses and securing the possibility of financial sustainability based on medical expenses according to income.
Rare diseases are not so much developed drugs, but they are expensive to treat, and most of them are genetic. As the process of treating them is prolonged for a lifetime, the burden of disease and the economic burden of rare disease patients and their families is overloaded which can eventually lead to the poverty and the decline of the household of the rare disease patient. In order to reduce the burden of rare diseases and to strengthen the role of health insurance as a social safety net, a system of deduction of 10% of co-payment rate was implemented on July 1, 2009. The purpose of this study is to investigate the effects of expanding benefit coverage for rare diseases implemented in 2009 on the medical utilization of rare diseases and the reduction of burden of household medical expenses. The control group, which is not a policy included group, was selected as a liver disease (severe disease) or hypertension (chronic disease), and was divided according to the period of treatment. The analysis used the NHIS DB of the National Health Insurance Service to identify patients' medical use and household income between 2008 and 2010. The association between policy changes and health care utilization(the number of hospital visits, total medical expenses, out-of-pocket payment) and incidence of catastrophic health expenditure(CHE) is evaluated by pre-post assessment applying multiple Difference-in-Difference model adjusting for sex, age, categories of the insured(the employee insured and the self-employed insured), co-morbidity and disability. As a result of the analysis, the policy implementation of expanding benefit coverage policy for Rare Diseases in 2009 was associated with increased the medical use (number of hospital visits) and total medical expenses of the rare diseases group compared with the control group. On the other hand, we did not confirm the effect of the policy associating with better CHE rate, which has been confirmed by the intersection term. Since, The causal effects caused by the increased medical use, the policy have not affected the overburdened medical costs of households with rare diseases. In order to achieve the policy goals of the "Rare Disease Act" and "Rare Disease Comprehensive Management Plan" implemented in 2016 for the management of rare diseases at the national level and to expand the coverage of health insurance coverage to extreme rare diseases, It is necessary to adopt a policy to extend the whole coverage like the “Catastrophic healthcare expenses support policy” which has the possibility of reducing the medical burden of the household and reducing the burden of the medical expenses and securing the possibility of financial sustainability based on medical expenses according to income.
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