+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: a study of the Korean health panel survey (2008-2012)



The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: a study of the Korean health panel survey (2008-2012)



Bmc Health Services Research 15: 489



Private health insurance in South Korea mainly functions as supplementary and complementary health insurance that compensates for insufficient coverage by National Health Insurance. However, full private coverage of public sector cost-sharing led to the problem of encouraging moral hazard-induced utilization, resulting in a policy change that occurred in October 2009. At that time, the Korean government introduced a minimum cost-sharing policy for indemnity health insurance. The purpose of this study was to analyze the effect of cost-sharing in private health insurance on health care utilization. We analyzed data collected from the Korean Health Panel Survey from October 2008 to December 2011. We restricted the two groups to 803 purchasers with indemnity health insurance and 7023 non-purchasers who did not obtain any private health insurance. A difference-in-difference analysis was used to evaluate the effect of the 2009 policy. After the policy change, the utilization of outpatient visits by purchasers gradually decreased more than non-purchasers (0.015 in 2009 [p = 0.758], -0.117 in 2010 [p < 0.016], and -0.140 in 2011 [p = 0.004]). However, utilization of inpatient services was not statistically significant. Notably, the magnitude of the cost-sharing effect in indemnity health insurance was stronger for those receiving medical aid. Among this group, utilization of outpatient services (after the policy change in 2009) decreased more so than non-purchasers. Patients with three or more chronic diseases have not changed their health care utilization. Our results implied meaningful lessons for decision-makers and future health insurance policies in Korea and other countries in terms of cost-sharing in medical care. When policy makers intend to implement the cost-sharing, a different copayment scheme is needed according to the socioeconomic status or disease severity.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059057043

Download citation: RISBibTeXText

PMID: 26510421

DOI: 10.1186/s12913-015-1153-0


Related references

Impact of type of insurance plan on access and utilization of health care services for adults aged 18-64 years with private health insurance: United States, 2007-2008. Nchs Data Brief 2010(28): 1-8, 2010

Utilization of Osteoporosis-Related Health Services: Use of Data from the Korean National Health Insurance Database 2008-2012. Journal of Korean Medical Science 33(3): E20, 2018

Effect of private health insurance on health care utilization in a universal public insurance system: a case of South Korea. Health Policy 113(1-2): 69-76, 2013

Factors Determining Children's Private Health Insurance Enrolment and Healthcare Utilization Patterns: Evidence From the 2008 to 2011 Health Panel Data. Journal of Preventive Medicine and Public Health 48(6): 319-329, 2015

Is the self-reported private health insurance status in the National Health Survey representative of private health insurance coverage in Australia?. Australian and new Zealand Journal of Public Health 34(6): 572-577, 2010

Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys. Journal of Preventive Medicine and Public Health 49(2): 118-128, 2017

Effects of public and private health insurance on medical service utilization in the National Health Insurance System: National panel study in the Republic of Korea. Bmc Health Services Research 16(1): 503, 2016

Inequalities in health risks, morbidity and health care of children by health insurance of their parents (statutory vs. private health insurance): results of the German KiGGS study. Gesundheitswesen ) 74(10): 627-638, 2012

Differences in Health Care Needs, Health Care Utilization, and Health Care Outcomes Among Children With Special Health Care Needs in Ohio: A Comparative Analysis Between Medicaid and Private Insurance. Journal of Public Health Management and Practice 23(1): E1-E9, 2018

Effect of having private health insurance on the use of health care services: the case of Spain. Bmc Health Services Research 17(1): 716, 2017

The effect of complementary private health insurance on the use of health care services. International Journal of Health Economics and Management 17(1): 1-27, 2017

The effect of private health insurance on medical care utilization and self-assessed health in Germany. Health Economics 19(9): 1048-1062, 2010

Federal regulation comes to private health care financing: the group health insurance provisions of the Health Insurance Portability and Accountability Act of 1996. Annals of Health Law 7: 183-215, 1998

The private health insurance contract between the National Dental Economics Commission and the Commission on Employee's National Health Insurance/Employees' Private Health Insurance in the resolution of 1 January 1981. Zahnarztliche Mitteilungen 70(23): 1547-1554, 1980

Effects of private health insurance on health care utilization and expenditures in Korean cancer patients: focused on 5 major cancers in one cancer center. Journal of Preventive Medicine and Public Health 40(4): 329-335, 2007