The effect of extension of benefit coverage for cancer patients on health care utilization across different income groups in South Korea
- 482 Downloads
To provide financial protection against catastrophic illness, the Korean government expanded the National Health Insurance (NHI) benefit coverage for cancer patients in 2005. This paper examined whether the policy improved the income-related equality in health care utilization. This study analyzed the extent to which the policy improved income-related equality in outpatient visits, inpatient days, and inpatient and outpatient care expenditure based on triple difference estimator. Using nationwide claims data of the NHI from 2002 to 2004 and from 2006 to 2010, we compared cancer patients as a treatment group with liver disease as a control group and low-income group with the highest-income group. The results showed that the extension of NHI benefits coverage led to an increase in the utilization of outpatient services across all income groups, but with a greater increase for the low-income groups, among cancer patients. Moreover, the policy led to a less decrease in the utilization of inpatient services for the low-income group while it decreased across all income groups. Our finding suggests that the extension of NHI benefits coverage improved the income-related equality in health care utilization.
KeywordsHealth care utilization Cancer Universal coverage Income-related equality South Korea
JEL ClassificationI13 I14 I18
This study was funded by the National Evidence-based Healthcare Collaborating Agency (NECA), Project No. NM2011-001, and approved by the Institutional Review Board of the same institute. We thank the NECA and also acknowledge support from the National Health Insurance Corporation that provided the data for our study. The anonymous reviewer and the editor of this journal provided insightful comments. We would like to thank Juhwan Oh, Hongsoo Kim and Youn Jung for their comments and supports.
- Bae, J.-Y. (2010). Impacts of health insurance coverage expansion on health care utilization and health status. Korean Journal of Social Welfare Studies, 41(2), 35–65.Google Scholar
- Korda, R. J., Clements, M. S., & Kelman, C. W. (2009). Universal health care no guarantee of equity: Comparison of socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction and angina. BMC Public Health, 9, 460. doi: 10.1186/1471-2458-9-460.PubMedCentralPubMedCrossRefGoogle Scholar
- Lee, Y.-J. (2009). A study on the influences of changes to the co-payment of cancer patients of their uses of medical services. The Journal of Korean Public Policy, 11(1), 3–25.Google Scholar
- Liao, P.-A., Chang, H.-H., & Yang, F.-A. (2012). Does the universal health insurance program affect urban-rural differences in health service utilization among the elderly? Evidence from a longitudinal study in Taiwan. The Journal of Rural Health, 28(1), 84–91. doi: 10.1111/j.1748-0361.2011.00363.x.PubMedCrossRefGoogle Scholar
- Long, J. S. (1997). Regression models for categorical and limited dependent variables. New York: SAGE Publications.Google Scholar
- Lu, J.-F. R., Leung, G. M., Kwon, S., Tin, K. Y. K., Van Doorslaer, E., & O’Donnell, O. (2007). Horizontal equity in health care utilization evidence from three high-income Asian economies. Social Science and Medicine, 64(1), 199–212. doi: 10.1016/j.socscimed.2006.08.033.PubMedCrossRefGoogle Scholar
- Mackenbach, J. P., Veerman, J. L., Barendregt, J. J., & Kunst, A. E. (2004). Health inequalities and HIA. In J. S. Kemm & S. Palmer (Eds.), Health Impact Assessment. Oxford: Oxford University Press.Google Scholar
- Mott, D. A., Thorpe, J. M., Thorpe, C. T., Kreling, D. H., & Gadkari, A. S. (2010). Effects of Medicare Part D on drug affordability and use: Are seniors with prior high out-of-pocket drug spending affected more? Research in Social and Administrative Pharmacy, 6(2), 90–99. doi: 10.1016/j.sapharm.2010.02.004.PubMedCrossRefGoogle Scholar
- O’Donnell, O. A., Bank, W., & Wagstaff, A. (2008a). Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation: World Bank.Google Scholar
- OECD (2012). OECD Health Data.Google Scholar