Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
This study aimed to investigate pediatric health access by describing the ecology of medical care for children and adolescents in a medical environment where a well-balanced system between national health insurance (NHI) and private medical insurance (PMI) is required. Data from 2746 individuals age...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-07-01
|
| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/9/8/1101 |
| _version_ | 1797410804132216832 |
|---|---|
| author | Dong-Hee Ryu Yong-jun Choi Jeehye Lee |
| author_facet | Dong-Hee Ryu Yong-jun Choi Jeehye Lee |
| author_sort | Dong-Hee Ryu |
| collection | DOAJ |
| description | This study aimed to investigate pediatric health access by describing the ecology of medical care for children and adolescents in a medical environment where a well-balanced system between national health insurance (NHI) and private medical insurance (PMI) is required. Data from 2746 individuals aged 18 years old and younger were used. Of the participants, 87.3% had private medical insurance. Of the 1000 children, in an average month, 404 visited a clinic, 67 visited a hospital outpatient department (OPD), 49 visited an OPD in a tertiary hospital, 11 received emergency care, 5 received inpatient care in a hospital, and 9 were hospitalized. The generalized estimating equation models adjusted for age, sex, economic status, and pediatric comorbidity index were used for multivariate analysis. Receiving ambulatory care services in clinics was significantly more likely among children and adolescents with private medical insurance (adjusted odds ratio [aOR] = 1.16 [95% confidence interval [CI]: 1.00–1.35]). Receiving ambulatory care services in clinics was significantly more likely among indemnity type policyholders (aOR = 1.23 [1.05–1.45]) and single policyholders (aOR = 1.18 [1.00–1.37]). Countries with national health insurance schemes should continuously practice the proper regulation and management of PMI, including reviewing PMI compensation measures, NHI reimbursement standards, and consumers’ perspectives on NHI and PMI. |
| first_indexed | 2024-03-09T04:35:32Z |
| format | Article |
| id | doaj.art-0f8cd8196bb4461e968bf3ba1ca39982 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T04:35:32Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-0f8cd8196bb4461e968bf3ba1ca399822023-12-03T13:27:57ZengMDPI AGChildren2227-90672022-07-0198110110.3390/children9081101Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in KoreaDong-Hee Ryu0Yong-jun Choi1Jeehye Lee2Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu 42472, KoreaDepartment of Social and Preventive Medicine, College of Medicine, Hallym University, Chuncheon 24252, KoreaDepartment of Preventive Medicine, Eulji University School of Medicine, Daejeon 34824, KoreaThis study aimed to investigate pediatric health access by describing the ecology of medical care for children and adolescents in a medical environment where a well-balanced system between national health insurance (NHI) and private medical insurance (PMI) is required. Data from 2746 individuals aged 18 years old and younger were used. Of the participants, 87.3% had private medical insurance. Of the 1000 children, in an average month, 404 visited a clinic, 67 visited a hospital outpatient department (OPD), 49 visited an OPD in a tertiary hospital, 11 received emergency care, 5 received inpatient care in a hospital, and 9 were hospitalized. The generalized estimating equation models adjusted for age, sex, economic status, and pediatric comorbidity index were used for multivariate analysis. Receiving ambulatory care services in clinics was significantly more likely among children and adolescents with private medical insurance (adjusted odds ratio [aOR] = 1.16 [95% confidence interval [CI]: 1.00–1.35]). Receiving ambulatory care services in clinics was significantly more likely among indemnity type policyholders (aOR = 1.23 [1.05–1.45]) and single policyholders (aOR = 1.18 [1.00–1.37]). Countries with national health insurance schemes should continuously practice the proper regulation and management of PMI, including reviewing PMI compensation measures, NHI reimbursement standards, and consumers’ perspectives on NHI and PMI.https://www.mdpi.com/2227-9067/9/8/1101healthcareinsurance coveragenational health insurance |
| spellingShingle | Dong-Hee Ryu Yong-jun Choi Jeehye Lee Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea Children healthcare insurance coverage national health insurance |
| title | Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea |
| title_full | Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea |
| title_fullStr | Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea |
| title_full_unstemmed | Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea |
| title_short | Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea |
| title_sort | pediatric health access and private medical insurance based on the ecology of medical care in korea |
| topic | healthcare insurance coverage national health insurance |
| url | https://www.mdpi.com/2227-9067/9/8/1101 |
| work_keys_str_mv | AT dongheeryu pediatrichealthaccessandprivatemedicalinsurancebasedontheecologyofmedicalcareinkorea AT yongjunchoi pediatrichealthaccessandprivatemedicalinsurancebasedontheecologyofmedicalcareinkorea AT jeehyelee pediatrichealthaccessandprivatemedicalinsurancebasedontheecologyofmedicalcareinkorea |