Impact of Coinsurance Reduction Policy on Healthcare Utilization Among Children Under 15.

BACKGROUND: On October 1, 2017, a new coinsurance reduction policy for children under 15 was introduced to minimize the lack of inpatient medical services for economic reasons and secure children's access to medical care. METHODS: This study analyzes the effect of this coinsurance reduction policy on healthcare utilization using data from the National Health Insurance Service-National Sample Cohort between 2015 and 2019. Groups were classified by 3 case groups and a control group according to age. The dependent variables were inpatient cost, admission, length of hospitalization, outpatient cost and visit, and total cost. The difference-in-differences method was used to examine changes in healthcare utilization among the case and control groups after policy implementation. RESULTS: Children of the age group 1-5 exhibited an increase in inpatient services and a decrease in outpatient services. There was a 16.17% increase in inpatient cost, 8.55% increase in inpatient admission, 10.67% increase in inpatient length of hospitalization, -9.14% decline in outpatient cost, and -6.79% decline in outpatient visits. Regarding children in the age groups of 6-10 and 11-15, the effect of the policy was inconclusive. CONCLUSION: The reduction in coinsurance rate policy in hospitalization among children has increased inpatient services and reduced outpatient services for 1-5-year-olds-a substitute effect was observed in this group. There is need for further research to examine the long-term effects of the coinsurance reduction policy.

Nationwide cancer incidence in Korea, 1999~2001; first result using the national cancer incidence database.

PURPOSE: The first Korean national population-based cancer registry using nationwide hospital-based recording system and the regional cancer registries provided the source to obtain national cancer incidences for the period 1999~2001. MATERIALS AND METHODS: The incidence of cancer in Korea was calculated based on the Korea Central Cancer Registry database, data from additional medical record review survey, the Regional Cancer Registry databases, site-specific cancer registry databases, and cancer mortality data from the Korea National Statistical Office. Crude and age-standardized rates were calculated by sex for 18 age groups. RESULTS: The overall crude incidence rates (CR) were 247.3 and 188.3 per 100,000 for men and women and the overall age-standardized incidence rates (ASR) were 281.2 and 160.3 per 100,000, respectively. Among men, five leading primary cancer sites were stomach (CR 58.6, ASR 65.6), lung (CR 42.1, ASR 50.9), liver (CR 41.9, ASR 44.9), colon and rectum (CR 24.2, ASR 27.3) and bladder (CR 7.7, ASR 9.2). Among women, the most common cancers were stomach (CR 30.8, ASR 25.8), breast (CR 25.7, ASR 21.7), colon and rectum (CR 19.6, ASR 16.7), uterine cervix (CR 18.4, ASR 15.5), and lung cancer (CR 15.1, ASR 12.4). In 0~14 age group, leukemia was most common for both sexes. For men, stomach cancer was most common in 15~64 age group, but lung cancer was more frequent for over 65 age group. For women, thyroid cancer in 15~34 age group, breast cancer in 35~64 age group, and stomach cancer in over 65 age group were most common for each age group. The proportions of death certificate only were 7.5% for men and 7.4% for women. CONCLUSION: This is the first attempt to determine the national cancer incidence and this data will be useful to plan for research and national cancer control in Korea.