4대 중증질환 보장성 강화 정책 이후 중증질환자의 의료 이용 변화에 관한 분석

The purpose of this study is to analyze the impacts of the health insurance policy for 4 major disease, on outpatient medical use of people with severe illness. In the previous studies, only the result of the lack or ineffectiveness of the policy was presented, but the study of the data of the medical expenses immediately after the implementation of the policy was conducted. Therefore, we analyzed the change of outpatient medical expenditure more than two years after the policy implementation and tried to examine the effectiveness of the policy. In order to examine the effectiveness of the policy, we used the data of 2012 and 2015 among the data of the Korea Health Panel jointly administered by the Korea Institute for Health and Social Affairs and the National Health Insurance Service. Statistical analysis was performed using Difference-in-Differences analysis to compare the difference of change rates between before and after policy implementation of treatment group and control group. The results of the study showed that the medical expenses of the 4 major disease patients decreased after the policy implementation, compared to the medical use of the non-severe ones. All of the deductibles, medical charges, non-medical expenses and total medical expenses decreased. This is due to the decrease in the number of medical use of patients with severe illness. The reason for the decrease in the number of medical use is the phenomenon that is caused by the decrease in the demand for the incentives of the suppliers due to the non-accrual items of the 4 major diseases. As a result, it was found that the health insurance policy for 4 major disease showed statistically significant reductions in outpatient copayments and non-provisional medical expenses for severely ill patients. Therefore, it can be seen that the effectiveness of the health insurance policy for 4 major disease has increased over time. In this study, since only the outpatient medical expenses are compared, it is necessary to study the comparison of the inpatient medical expenses afterwards.