Effect of private health insurance on health care utilization in a universal health insurance system: A case of South Korea

민간 의료 보험 가입이 의료 이용에 미치는 영향

  • Lee, You Jin (Department of Economics, Sungkyunkwan University) ;
  • Lee, Jinhyung (Department of Economics, Sungkyunkwan University)
  • 이유진 (성균관대학교 경제학과) ;
  • 이진형 (성균관대학교 경제학과)
  • Received : 2018.01.29
  • Accepted : 2018.06.12
  • Published : 2018.06.30

Abstract

Purpose: this study investigates the effect of private health insurance on healthcare utilization. Methodology: For the analysis, we employed the three level nested two part model. Findings: the private health insurance adoption was associated with higher health care utilization. In particular, indemnity and fixed insurances adoption was associated with higher probability of outpatient visit, the number of outpatient visit and outpatient cost. While indemnity insurance adoption was associated with higher inpatient admission probability and inpatient days, fixed insurance adoption was associated only with higher inpatient admission probability. Practical Implications: indemnity and fixed insurance adoption were related with the adverse selection as well as moral hazard.

References

  1. Park SB, Jeong KH, 'The Determinants of Private Health Insurance and Its Effects on Medical Utilization in Korea. Insurance Journal. 2011; (88): 23-49.
  2. Huh SI, LEE SY, Impact of Complementary Private Health Insurance on Public Health Spending in Korea, Health Policy and Management, 2007; 17(2): 1-17. https://doi.org/10.4332/KJHPA.2007.17.2.001
  3. Ettner, Susan L. Adverse selection and the purchase of Medigap insurance by the elderly. Journal of health economics. 1997; 16(5): 543-562. https://doi.org/10.1016/S0167-6296(97)00011-8
  4. Kang SW, You CH, Oh EH, Kwon YD. The impact of having private health insurance on healthcare utilization with controlling for endogeneity. Korean Health Economic Review, 2010, 16(1): 139-159.
  5. Kang SW, You CH, , Choi JH, Oh EH, Kwon YD. 'The Effect of Private Health Insurance on Health Care Utilization : Evidence from Korea Health Panel (2008-2010).' Korean Journal of Health Service Management, 2014; 8(2): 101-113. https://doi.org/10.12811/kshsm.2014.8.2.101
  6. Yoon HS. The impact of having private health insurance on Utilization. Korea Development Institutes. 2008; 30(2): 99-128.
  7. Kim DH. Effects of Fee-For-Service Health Insurance on Medical Consumption, 2014(98): 61-90.
  8. Choi SE. The Role of Private Health Insurance and Health Service Utilization', Korean Applied Economics Journal, 2016; 18(4): 79-97
  9. You CH,, Kang SW, Kwon YD, Choi JH, Analysis of Effect of Indemnity Private Health Insurance on Medical Utilization Using Instrumental Variable Regression. Korea Contents Association, 2018; 18(1): 268-276
  10. Kim KO, Shin YJ, 'Effects of Buying a Medical Insurance for Actual Expense on Medical Cost', Critical Society Policy, 2017: 305-334
  11. Pauly, Mark V. Overinsurance and public provision of insurance: The roles of moral hazard and adverse selection. The Quarterly Journal of Economics 1974: 44-62.
  12. Manning W. and Marquis M., Health insurance: The tradeoff between risk pooling and moral hazard, Journal of Health Economics, 1996; 15(5): 609-639 https://doi.org/10.1016/S0167-6296(96)00497-3
  13. Einav L., Finkelstein A., Cullen M, Estimating Welfare in insurance markets using variation in prices, Quarterly Journal of Economics., 2010 3:844-921
  14. Einav, Liran, and Amy Finkelstein. Selection in Insurance Markets: Theory and Empirics in Pictures. Journal of Economic Perspectives, 2011; 25(1): 115-38 https://doi.org/10.1257/jep.25.1.115
  15. Nyman, JA, Is 'Moral Hazard' Inefficient? The Policy Implications of A New Theory, Health Aff. 2004; 23(5): 194-199