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      An evaluation on the effect of the copayment waiver policy for Korean hospitalized children under the age of six

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          Abstract

          Background

          In January 2006, the Korean government implemented a copayment waiver policy for hospitalized children under the age of 6 years to reduce the economic burden on patients. This policy was implemented from 2006 to 2007 in Korea and involved hospitalized children under the age of 6 years. The goal of this study is to evaluate the effect of the copayment waiver policy on health insurance beneficiaries.

          Methods

          The change in medical service utilization before and after the policy implementation was analyzed using data from the national health insurance corporation (NHIC) and compared with medical aid beneficiaries who were already exempt from copayment. The “difference in difference” method was applied to determine the net effect of the copayment waiver policy.

          Results

          The net effect of policy implementation on NHIC beneficiaries was unclear by the “difference in difference” method because the number of inpatient days and hospital expenditure after policy implementation showed opposite results. The copayment waiver policy did not decrease the intensity of health care utilization when compared with the medical aid beneficiaries group. Among the NHIC beneficiaries, patients who utilized medical services for fatal disease and those with the low premiums group were more affected by the policy.

          Conclusions

          The net effect of copayment waiver policy remains unclear. Therefore, further studies are needed to determine the effects of policies implemented to reduce the economic burden on patients, such as the herein-described copayment waiver policy.

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          Most cited references19

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          Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage.

          South Korea introduced mandatory social health insurance for industrial workers in large corporations in 1977, and extended it incrementally to the self-employed until it covered the entire population in 1989. Thirty years of national health insurance in Korea can provide valuable lessons on key issues in health care financing policy which now face many low- and middle-income countries aiming to achieve universal health care coverage, such as: tax versus social health insurance; population and benefit coverage; single scheme versus multiple schemes; purchasing and provider payment method; and the role of politics and political commitment. National health insurance in Korea has been successful in mobilizing resources for health care, rapidly extending population coverage, effectively pooling public and private resources to purchase health care for the entire population, and containing health care expenditure. However, there are also challenges posed by the dominance of private providers paid by fee-for-service, the rapid aging of the population, and the public-private mix related to private health insurance.
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            Identification and Inference in Nonlinear Difference-in-Differences Models

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              Health insurance and the demand for medical care: evidence from a randomized experiment.

              We estimate how cost sharing, the portion of the bill the patient pays, affects the demand for medical services. The data come from a randomized experiment. A catastrophic insurance plan reduces expenditures 31 percent relative to zero out-of-pocket price. The price elasticity is approximately -0.2. We reject the hypothesis that less favorable coverage of outpatient services increases total expenditure (for example, by deterring preventive care or inducing hospitalization).
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                Author and article information

                Contributors
                ksy921@naver.com
                yoonsj02@korea.ac.kr
                parenchyme@gmail.com
                kimyes1202@daum.net
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                20 April 2015
                20 April 2015
                2015
                : 15
                : 170
                Affiliations
                [ ]Bureau of Welfare Administration Support, Ministry of Health and Welfare, Sejong, South Korea
                [ ]Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
                [ ]Department of Preventive Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea
                [ ]Division for Healthcare Technology Assessment Research, National Evidence-based healthcare Collaborating Agency (NECA), Seoul, South Korea
                Article
                836
                10.1186/s12913-015-0836-x
                4422598
                25928166
                b73bf3aa-8204-4e30-ac4f-78a2994f4d6c
                © Kwak et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                : 16 January 2013
                : 6 April 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                copayment,copayment waiver policy,medical utilization,difference in difference,korea

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