title: Impact of co-payment for outpatient utilization among Medical Aid beneficiaries in Korea: A 5-year time series study.
abstract: BACKGROUND
  The Korean government implemented an outpatient co-payment scheme in July 2007 to control Medical-Aid beneficiaries' overutilization of healthcare services.
  
  
  OBJECTIVE
  To assess changes in the utilization of medical services resulting from the outpatient co-payment scheme.
  
  
  METHODS
  410,142 subjects were selected and health insurance reimbursement data from July 2006 to June 2011 was examined. We assessed the changes in the total medical cost, total adjusted patient days, inpatient days, inpatient total medical cost, the number of outpatient visits, and outpatient total medical cost using segmented regression analysis.
  
  
  RESULTS
  Following the introduction of the policy, the number of outpatient visits per person fell by 0.16 days in July 2008, and by 0.06 days in July 2010, compared to June 2007. The outpatient total medical cost per person rose by $4.11 in July 2010 compared to June 2007. The inpatient utilization increased constantly during the period of the study. So the total medical cost as well as the total adjusted number of patient days also increased constantly.
  
  
  CONCLUSIONS
  The outpatient co-payment policy was effective for reducing the number of outpatient visits. It could not control the cost per outpatient visit and inpatient utilization. So the total medical cost was increased.
authors: Department of Healthcare Management, Eulji University, Republic of Korea. Electronic address: kb53545@gmail.com.
authors: Ki-Bong
authors: KB
authors: Yoo
authors: National Health Insurance Service, Republic of Korea. Electronic address: hongahn@nhis.or.kr.
authors: Hong-Uk
authors: HU
authors: Ahn
authors: Institute of Health Services Research, Yonsei University, Republic of Korea; Department of Preventive Medicine, College of Medicine Yonsei University, Republic of Korea. Electronic address: ecpark@yuhs.ac.
authors: Eun-Cheol
authors: EC
authors: Park
authors: Institute of Health Services Research, Yonsei University, Republic of Korea; Graduate School of Public Health, Yonsei University, Republic of Korea. Electronic address: thkim@yuhs.ac.
authors: Tae Hyun
authors: TH
authors: Kim
authors: Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Republic of Korea. Electronic address: sunjkim0623@gmail.com.
authors: Sun Jung
authors: SJ
authors: Kim
authors: Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Republic of Korea. Electronic address: kwon.jeounga@gmail.com.
authors: Jeoung A
authors: JA
authors: Kwon
authors: Institute of Health Services Research, Yonsei University, Republic of Korea; Graduate School of Public Health, Yonsei University, Republic of Korea. Electronic address: leevan@yuhs.ac.
authors: Sang Gyu
authors: SG
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis / Q000191:economics*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005249:Fees and Charges / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D056910:Republic of Korea
keywords: Co-payment; Cost sharing; Medical services; Medical-Aid; Segmented regression