An Evaluation of Universal Health Insurance in the Elderly Burden of Disease, Utilization, and Costs in the Republic of Korea

• Published in: Journal of aging and health Vol. 14; no. 2; pp. 286 - 309
• Main Authors: Peabody, John W., Robalino, David A., Kim, Jin Ho
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA Sage Publications 01-05-2002; SAGE PUBLICATIONS, INC
• Subjects: Age Distribution; Aged; Cost Containment; Cost of Illness; Costs and Cost Analysis; Diagnosis-Related Groups - economics; Disease; Elderly; Health Care Costs; Health care expenditures; Health Care Utilization; Health Expenditures; Health Insurance; Health services utilization; Health technology assessment; Humans; Insurance, Health - economics; Insurance, Health - utilization; Korea; Older people; Quality of Health Care; Sex Distribution; Socialized Medicine; South Korea; Utilization Review; Korea
• ISSN: 0898-2643; 1552-6887
• DOI: 10.1177/089826430201400206

Objective: This article evaluates Korea’s national health insurance system for the elderly by simultaneously examining disease patters, demand for care, utilization, costs of care, and facility type. Methods:Claim records (N= 8,306,976) for 1995 to 1997 were obtained from the Youndeoung-Po district for four insurance categories. Utilization is examined using a probit model; a linear regression model is used to compare costs. Findings:Insurees averaged 10.6 medical visits per year, most commonly for acute respiratory diseases. The elderly were more likely to seek care for circulatory problems, use more inpatient services, and rely on hospitals for outpatient care. Insurance costs for the elderly poor were markedly higher, and overall care for the elderly was higher per visit. Discussion:By simultaneously analyzing utilization rates, disease patterns, and relative costs of care, policymakers may be able to avert a financing crisis. Stronger pricing strategies and better disease targeting would adjust utilization and increase efficiency of health expenditures.