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

The Seoul Institute, 57 Nambusunhwan-ro, 340-gil, Seocho-gu, Seoul 06756, Korea
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Int. J. Environ. Res. Public Health 2018, 15(4), 772; https://doi.org/10.3390/ijerph15040772
Received: 8 March 2018 / Revised: 2 April 2018 / Accepted: 11 April 2018 / Published: 17 April 2018
(This article belongs to the Section Health Economics)
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. View Full-Text
Keywords: medical aid; preventable hospitalization; avoidable admission; length of stay; medical security medical aid; preventable hospitalization; avoidable admission; length of stay; medical security
MDPI and ACS Style

Kim, J.; Shon, C. The Effects of Health Coverage Schemes on Length of Stay and Preventable Hospitalization in Seoul. Int. J. Environ. Res. Public Health 2018, 15, 772.

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