title: Impact of health insurance status changes on healthcare utilisation patterns: a longitudinal cohort study in South Korea.
abstract: OBJECTIVE
  The study examined medical care utilisation by health insurance status changes.
  
  
  METHODS
  The Korean Welfare Panel Study (KoWePs) was used.
  
  
  METHODS
  This study analysed 14,267 participants at baseline (2006).
  
  
  METHODS
  The individuals were categorised into four health insurance status groups: continuous health insurance, change from health insurance to Medical Aid, change from Medical Aid to health insurance, or continuous Medical Aid.
  
  
  METHODS
  Three dependent variables were also analysed: days spent in hospital; number of outpatient visits; and hospitalisations per year. Longitudinal data analysis was used to determine whether changes in health insurance status were associated with healthcare utilisation.
  
  
  RESULTS
  The number of outpatient visits per year was 0.1.363 times higher (p<0.0001) in the continuous Medical Aid than in the continuous health insurance group. The number of hospitalisations per year was 1.560 times higher (p<0.001) in new Medical Aid and -0.636 times lower (p<0.001) in new health insurance than in continuous health insurance group. The number of days spent in hospital per year was -0.567 times lower (p=0.021) in the new health insurance than in the continuous health insurance group.
  
  
  CONCLUSIONS
  Health insurance beneficiaries with a coverage level lower than Medical Aid showed lower healthcare utilisation, as measured by the number of hospitalisations and days spent in hospital per year.
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
authors.forename: Jae-Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
authors.forename: Sang Gyu
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Health Administration, College of Health Sciences, Yonsei University, Wonju, gwangwondo, Republic of Korea.
authors.forename: Kwang-Soo
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung-In
authors.initials: SI
authors.lastname: Jang
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Cho
authors.affiliation: Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000639:trends*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D056910:Republic of Korea; D055815:Young Adult
keywords: HEALTH ECONOMICS; HEALTH SERVICES ADMINISTRATION & MANAGEMENT