Korea Journal of Hospital Management (한국병원경영학회지)

Korean Society of Hospital Management (한국병원경영학회)
권호 표지

The Effect of integrated health and welfare services on the control of medical use and medical expenses in Korean Veteran's Hospitals

보훈병원 통합의료복지서비스가 의료이용과 의료비 절감에 미치는 효과 분석

  • 구길환 (한국보훈복지의료공단) ;
  • 동재용 (건강보험심사평가원) ;
  • 이경화 (송호대학교 보건행정과) ;
  • 서영준 (연세대학교 대학원 보건행정학과)
  • Received : 2021.03.29
  • Accepted : 2021.06.02
  • Published : 2021.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study aims to examine the effect of integrated health and welfare(IHW) services on medical use and medical expenses in Korean Veteran Hospitals. Data on the volume of medical use and medical expenses were collected from two patient groups of 5 Veterans' Hospitals: the beneficiary group who has received IHW services and the non-beneficiary group who has not. Each group was composed of 265 patients respectively. The results of the study revealed that the volume of home nursing services, home rehabilitation services, ambulatory services have increased significantly, whereas the average length of stay, number of using emergency services, and average medical expenses have decreased after receiving integrated health services in the beneficiary group. In contrast, the non-beneficiary group showed much more increase both in the volume of inpatient and outpatient services, as well as the average medical expenses, compared to those of the beneficiary group. This results imply that the provision of IHW services have positive impacts on the enhancing the effectiveness of the medical resources utilization for the veteran patients.

Keywords

References

  1. KOSIS National Statistics Portal. Total Survey Population. Daejeon: KOSIS National Statistics Portal; 2019.
  2. Shin YS, Yoon JH. Exploration of Korean Integrated Medical System Model. Journal of the Korean Society for Health Administration 2014; 24(4):304-311. https://doi.org/10.4332/KJHPA.2014.24.4.304
  3. Korea Veterans Health Service. Veterans Health Statistics in Hand. Wonju : Korea Veterans Health Service; 2017.
  4. Shin YS, Yoon JH. Exploration of Korean Integrated Medical System Model. Journal of the Korean Society for Health Administration 2014; 24(4):304-311. https://doi.org/10.4332/KJHPA.2014.24.4.304
  5. Lee YH. Response to the ultra-aged society and health care. Health and Welfare Forum 2015; (225):2-4.
  6. Kim JE, Hwang JW, Park JS. Comparative analysis between countries on integrated domestic and international service provision system to reduce medical expenses. Korea Health Industry Promotion Agency; 2015.
  7. Baek JH, Lee SM, Kim KA, Kwak DS. Development of an integrated service provision model for chronic disease management in connection with local community resources . National Health Insurance Corporation Health Insurance Policy Research Institute; 2016.
  8. Lee KS, Shin YS, Kim CW. Community-oriented integrated service system. Institute for Health and Welfare Policy Issue Paper 2017;21(1):1-34.
  9. Lee GS, Jeong HS, Hwang SW, Choi DB. A Study on Efficient Management of Elderly Medical Expenses for the Aged Society. Institute for Health and Welfare Policy; 2017.
  10. Kodner DL. Spreeuwenberg C. Integrated care: meaning, logic, applications, and implications-A discussion paper. International Journal of Integrated Care 2002; 2.
  11. Ouwens M, Wollersheim H, Hermens R, Hulscher M & Grol R(2005), ,Integrated care programmes for chronically ill patients: a review of systematic reviews :International Journal for Quality in Health Care 2005; 17(2), 141-146. https://doi.org/10.1093/intqhc/mzi016
  12. MacAdam M. Frameworks of Integrated Care for the Elderly, CPRN Research Report 2008.
  13. Doriling G, Fountaine T, McKenna S & Brindan Suresh(2015). The evidence for integrated care, Mckinsey&Company; Healthcare Practice March 2015, 1-23.
  14. Druss B, Rohrbaugh R, Levinson C & Rosenheck R(2001). Integraged Medical Care for Patients with Serious Psychiatric Illness, a Randomized Trial. American Medical Associations. ARCH GEN PSYCHIATRY 58.
  15. Song TM. Analysis of the Mediating Effect of Stress Vulnerable Factors on the Use of Outpatient Medical Services in Old Age Using Anderson Behavior Model. Health and Social Research 2013;33(1):547-576.
  16. Andersen RM & Newman JF(1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly - Health and Society; 51(1): 95-124. https://doi.org/10.2307/3349613
  17. Lee DY, Park JD. A Study on the Determinants of Decision to Participate in Health Promotion Program of Elderly Living Alone at Home : Application of Anderson Model. Social welfare policy 2011;38(4):1-23. https://doi.org/10.15855/swp.2011.38.4.1
  18. Lee JJ. Comparative review of the different grades of national merit and the grades of registered persons with disabilities. Korea Employment Agency for the Disabled Employment Development Institute; 2009.
  19. Yoo KB, Choi JW, Kim BS, Kim TH. A Study on Estimation of Socioeconomic Burden Due to Chronic Kidney Disease in Korea. Korean Health Research 2014;40(3):13-23.
  20. Rosenbaum, PaulR, and Donald B, Rubin. The central role of the propensity score in observational studies for causal effects. Biometrika 1983;70(1):41-55. https://doi.org/10.1093/biomet/70.1.41
  21. Kwon HJ, Jo YW, Go JY. The Effect of Long-Term Care Insurance System for the Elderly on the Quality of Life and Satisfaction with Family Relationships of the Elderly and Their Dependents. Korean Social Welfare Studies 2011;301-326.
  22. Na YG. The effect of the policy on treatment improvement cost for nursing care workers on wage increase [dissertation]. Wonju: Yonsei University; 2017.
  23. Choi JG, Jeong HS. The effect of reducing the burden of medical expenses of this special calculation system through double difference analysis. Health and Policy Research 2012;18(4):1-19.
  24. Kwon KH, Lee DG, Seo IS. Analysis of the relationship between health insurance security reinforcement policy and private insurance expenditure. Gyeonggi Development Institute 2014;16(2):265-293.
  25. Jeon HS, Kang SK. Age Difference in Predicting Factors of Medical Service Use Between Young and Elderly Elderly: Implications for medical services in an aging society. Health and Social Research 2012;32(1):28-57.
  26. Shin MS, Lee YJ. Outpatient service use and health behavior. Journal of the Korea Contents Association 2013;13(5):342-353. https://doi.org/10.5392/JKCA.2013.13.05.342
  27. Eom S. Medical Use and Medical Expenses for Adult Multiple Chronic Diseases in Korea. [dissertation]. Gyeongsan: Yeungnam University; 2015.
  28. Hwang YH. Medical Use and Medical Expenditure of Korean Elderly as Seen by the Korean Medical Panel. Institute for Health and Social Affairs 2011;182(0):51-59.
  29. NHS Tower Hamlets Clinical Commissioning Group(2013-2014), Annual Report; 2015.
  30. NHS Greenwich Clinical Commissioning Group(2013-2014), Annual Report& Annual Accounts; 2015.
  31. Shin TG, Song JW, Song HG, Hong JG. A Study on the Clinical Characteristics of Emergency Room Multi-Visit Patients-Relevance of Emergency Room Overcrowding and Severity in Emergency Room Multi-Visit Patients-. Journal of the Korean Society of Emergency Medicine 2011;87-92.
  32. Kim SJ, Kim BR, Park SJ. Preventable Hospitalizations and Emergency Room Visits: Focus on Medical Aid Beneficiaries with Chronic Conditions. Health and Social Research 2014;19(1):43-53.
  33. Carter K, Chalouhi E, Mckenna S, & Richardson B. What it takes to make integrated care work, Mckinsey&Company, Health International; 2011.
  34. Lee JC. Introduction of US ACO.Utilization Status and Implications. Medical Policy Forum Korean Medical Association 2014;12(2):72-77.
  35. NHS Torbay and Southern Devon Health and Care Clinical Commissioning Group(2013- 2014), Annual Report; 2015.