[The medical use of the disabled among overusers of Medical Aid in Korea].
OBJECTIVE
In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers.


METHODS
Subjects (n=2,211) selected were > or =18-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression.


RESULTS
Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(), inpatient payment of 359,000, and outpatient payment of 183,000. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (82,000), elementary school or lower educational level (64,000), residence in a small city (82,000), lack of family support (61,000), kidney disability (673,000), intellectual disability (151,000), and multiple disabilities (119,000).


CONCLUSIONS
The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.
Shin
Sun Mi
SM
Office of Global Health Leadership, University of Illinois, Chicago, Illinois, USA.
Kim
Eui Sook
ES
Park
Chang Ki
CK
Lee
Hee Woo
HW
D000368:Aged; D003365:Costs and Cost Analysis; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008483:Medical Assistance / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D012959:Socioeconomic Factors