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The Association between Health Examination and Personal Medical Cost through Panel Survey

건강검진이 개인 의료비지출에 미치는 영향

  • Lee, Hwan Hyung (Department of Public Health, Graduate School, Kyungpook National University) ;
  • Park, Jae Yong (Department of Public Health, Graduate School, Kyungpook National University)
  • 이환형 (경북대학교 대학원 보건학과) ;
  • 박재용 (경북대학교 대학원 보건학과)
  • Received : 2013.12.30
  • Accepted : 2014.03.21
  • Published : 2014.03.31

Abstract

Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.

Keywords

References

  1. National Health Insurance Services. Annual statistical report on payment of medical service. Seoul: National Health Insurance Corporation; 2008.
  2. Tchoe BH, Nam SH, Shin YJ. Determinants of the national health expenditure: panel study. Korean J Health Policy Admin 2004;14(2):99-116. https://doi.org/10.4332/KJHPA.2004.14.2.099
  3. Lee KJ, Jung YH. The determinants of national health expenditure: a decision tree analysis. Korean J Health Policy Admin 2002;12(3):99-111. https://doi.org/10.4332/KJHPA.2002.12.3.099
  4. Shin YS, Kim YI, Kang KW, Kang MA, Kang YH, Kwon YD et al. Health policy and management. Seoul: Seoul National University Press: 2013. pp. 495.
  5. Cohen JT, Neumann PJ, Weinstein MC. Does preventive care save money? Health economics and the presidential candidates. N Engl J Med 2008;358(7):661-663. https://doi.org/10.1056/NEJMp0708558
  6. Russell LB. Prevention's potential for slowing the growth of medical spending. Washington (DC): National Coalition on Health Care; 2007.
  7. Ren A, Okubo T, Takahashi K. Comprehensive periodic health examination: impact on health care utilisation and costs in a working population in Japan. J Epidemiol Community Health 1994;48(5):476-481. https://doi.org/10.1136/jech.48.5.476
  8. National Health Insurance Services. Annual statistical report on health insurance services. Seoul: National Health Insurance Corporation; 2012.
  9. Lee WC, Lee SY. National health screening program of Korea. J Korean Med Assoc 2010;53(5):363-370. https://doi.org/10.5124/jkma.2010.53.5.363
  10. Choi YJ, Lee TJ, Kim JS, Kim JH, Im JY, Chi CI. A study on development of economic evaluation system in national health screening project [report]. Chuncheon: Hallyim University; 2008.
  11. Jee SH. A study on validity evaluation of exam items and analyses of medical cost in health screening [report]. Seoul: Yonsei University; 2005.
  12. Jeong HJ, Kwon HY, Han JT, Kim YJ, Lee AK. Cost-effectiveness analysis of type 2 DM screening program of National Health Insurance Corporation. Korean J Health Econ Policy 2012;18(4):21-39.
  13. Suka M, Yoshida K, Matsuda S. Effect of annual health checkups on medical expenditures in Japanese middle-aged workers. J Occup Environ Med 2009;51(4):456-461. https://doi.org/10.1097/JOM.0b013e3181973e02
  14. Mandelblatt J, Saha S, Teutsch S, Hoerger T, Siu AL, Atkins D, et al. The cost-effectiveness of screening mammography beyond age 65 years: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2003;139(10):835-842. https://doi.org/10.7326/0003-4819-139-10-200311180-00011
  15. Fukuda H, Ida O, Yamada A, Tatara K, Mizuno H, Yamaguchi N, et al. Relationship of utilization rate of health examination under the Elderly Act to medical expenditure and days of medical care for the elderly. Nihon Koshu Eisei Zasshi 1998;45(9):905-914.
  16. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 1995;36(1):1-10. https://doi.org/10.2307/2137284
  17. Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc 1973;51(1):95-124. https://doi.org/10.2307/3349613
  18. Babitsch B, Gohl D, von Lengerke T. Re-revisiting Andersen's Behavioral Model of Health Services Use: a systematic review of studies from 1998-2011. Psychosoc Med 2012;9:Doc11.
  19. Park HA, Song KY. A study on factors affecting individual's health care expenditure. Seoul J Nurs 1994;8(1):41-51.
  20. Chappell NL, Blandford AA. Health service utilization by elderly persons [abstract]. Canadian J Soc 1987;12(3):195-215. https://doi.org/10.2307/3340699
  21. Diehr P, Yanez D, Ash A, Hornbrook M, Lin DY. Methods for analyzing health care utilization and costs. Annu Rev Public Health 1999;20:125-44. https://doi.org/10.1146/annurev.publhealth.20.1.125
  22. Dodd S, Bassi A, Bodger K, Williamson P. A comparison of multivariable regression models to analyse cost data. J Eval Clin Pract 2006;12(1):76-86. https://doi.org/10.1111/j.1365-2753.2006.00610.x
  23. Manning WG, Basu A, Mullahy J. Generalized modeling approaches to risk adjustment of skewed outcomes data. J Health Econ 2005;24(3):465-488. https://doi.org/10.1016/j.jhealeco.2004.09.011
  24. Griswold M, Parmigiani G, Potosky A, Lipscomb J. Analyzing health care costs: a comparison of statistical methods motivated by medicare colorectal cancer charges. Biostatistics 2004;1(1):1-23.
  25. Im JY. The information effect of medical examination on individual health promotion behaviors: evidence from Korea. KDI J Econ Policy 2011;33(1):73-91. https://doi.org/10.23895/kdijep.2011.33.1.73
  26. Kim KA, Shin EK, Baek SJ, Choi YS, Jung KT. A study on catastrophic user-paid expenditure attributes for patient in national health insurance. Korean J Health Econ Policy 2011;17(3):75-99.
  27. Kim SG, Yu SH, Park WS, Chung WJ. Out-of-pocket health expenditures by non-elderly and elderly persons in Korea. J Prev Med Public Health 2005;38(4):408-414.
  28. Park JH, Lee JS, Lee JY, Hong JY, Kim SY, Kim SY, et al. Factors affecting national health insurance mass screening participation in the disabled. J Prev Med Public Health 2006;39(6):511-519.