Changes in Saturday outpatient volume and billings after introducing the Saturday incentive programme to clinics in South Korea: a longitudinal cohort study using claims data from 2012 to 2014.
In October 2013, the South Korean government introduced an incentive programme to increase the availability of Saturday treatment at clinics, hoping to increase the role of primary care providers as gatekeepers to medical care. To the best of our knowledge, no one has yet investigated this programme's effect on overall outpatient care. Our study aims to analyse the change in Saturday outpatient volume and billings in clinics that adopted the Saturday incentive programme.



Our study used 3 types of data from the period October 2012 to March 2014: National Health Insurance Service (NHIS) claims data, hospital evaluation data and medical institution data.



These data consisted of 66 825 881 outpatient cases from 2837 clinics.



Introducing the Saturday incentive programme.



We performed a multilevel analysis that adjusted for clinic-level and outpatient-level variables to examine the difference in the percentage of Saturday outpatient volume and billings after introducing the Saturday incentive programme.



The percentages of Saturday outpatient volume and billings were higher after introducing the programme (outpatient volume: β=2.065, p<0.001; outpatient billings: β=3.518, p<0.001). In addition, outpatient volume and billings on Friday and Saturday increased after introducing the programme, while those on weekdays, excluding Friday, decreased.



Our findings suggest that the Saturday incentive programme has affected clinic outpatient care and is a worthwhile health policy in terms of promoting primary care. Thus, it may improve healthcare accessibility and quality of care, and prevent inappropriate usage such as emergency room visits by providing patients with weekend clinic hours.
Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea Health Insurance Review and Assessment Service, Seoul, Republic of Korea.
Hyun Ji
HJ
Ha
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Kyu-Tae
KT
Han
Department of Health Administration and Management, Soonchunhyang University, Asan, Republic of Korea.
Sun Jung
SJ
Kim
Department of Health Services Administration, Yuhan University, Bucheon, Republic of Korea.
Tae Yong
TY
Sohn
Department of Preventive Medicine, CHA University College of Medicine, Pocheon, Republic of Korea.
Byungyool
B
Jeon
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Eun-Cheol
EC
Park
D039602:After-Hours Care / Q000458:organization & administration / Q000592:standards; D000553:Ambulatory Care / Q000458:organization & administration* / Q000592:standards; D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000592:standards; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010045:Outpatients; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards; D015397:Program Evaluation; D056910:Republic of Korea / Q000453:epidemiology; D016526:Workload
PRIMARY CARE; clinics; incentive program; outpatient care