[논문]노인장기요양보험 서비스 이용에 따른 의료이용 및 의료비 지출 양상의 변화

강희진; 장수현; 장선미

doi:10.4332/kjhpa.2022.32.4.389

[국내논문] 노인장기요양보험 서비스 이용에 따른 의료이용 및 의료비 지출 양상의 변화
The Impact of Long-term Care Insurance on Medical Utilization and Medical Cost in South Korea 원문보기

Health policy and management = 보건행정학회지, v.32 no.4, 2022년, pp.389 - 399

강희진 (가천대학교 약학대학) , 장수현 (가천대학교 약학대학) , 장선미 (가천대학교 약학대학)

Abstract ▼ AI-Helper

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.

주제어

표/그림 (6)

표 Table 1. Long-term care and general characteristics of the participants (N=41,726)
표 Table 2. Major diseases of medical utilization before long-term care grade
표 Table 3. Change in Proportion of hospitalization before and after long-term care grades*
표 Table 4. Change in the number of ambulatory visits before and after long-term care grade* (unit: times)
표 Table 5. Result of medical cost before and after long-term care by grade^†
그림 Figure 1. Result of medical cost before and after long-term care. Grade 1: those who fully require help from others for daily life with a score of 95 or higher; grade 2: those who require a considerable amount of help for daily life with a score of 75 or higher and less than 95; grade 3: those who require partial help for daily life with a score of 60 or higher and less than 75; grade 4: those who require partial help for daily life with a score of 51 or higher and less than 60; and grade 5: those who with dementia and a score of 45 or higher and less than 51. Vertical line: long-term care insurance intervention. Solid line: the pre- and post-intervention period trends. Dotted line: counterfactual trend line. (A) Total cost. (B) Total cost by grade. (C) Hospitalization cost. (D) Hospitalization cost by grade. (E) Ambulatory cost. (F) Ambulatory cost by grade.

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