ArticleBMC health services research2015
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).
Article in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- A systematic review of strategies used for controlling consumer moral hazard in health systems.BMC health services research · 2022Pooled it
- What drives patients' preferences for cancer care in South Korea's capital area? A study on preferences concerning cancer care facilities.BMC health services research · 2026Article
- No Cost Sharing for Public Assistance Recipients and Health Service Usage in Japan.JAMA health forum · 2025Article
- Unequal nursing: the impact of China's public health insurance on nursing services for older adults.BMC nursing · 2025Article
- Health promotion model in the utilization of health services for Indonesian social security agency for health participants.Narra J · 2024Article
- Key Risk Factors, Sex Differences, and the Influence of High-Intensity Exercise on Colorectal Carcinogenesis: A 10-Year Cohort Study Based on 1,120,377 Individuals from the NHISS Data.Current oncology (Toronto, Ont.) · 2024Article
- Does supplemental private health insurance impact health care utilization and seeking behavior of residents covered by social health insurance? Evidence from China National Health Services Survey.International journal for equity in health · 2024Article
- An epidemic of cataract surgery in Korea: the effects of private health insurance on the National Health Insurance Service.Epidemiology and health · 2024Observational
- Effects of a Dementia Special Care Unit on the Changes in Physical Function, Cognitive Function, and Problematic Behaviors among Nursing Home Residents.Annals of geriatric medicine and research · 2023Article
- Article
- Demand-side Interventions to Control Moral Hazard in Health Systems, Beneficial or Detrimental: A Systematic Review Study.Medical journal of the Islamic Republic of Iran · 2022Review
- Change in Denture Procedures after Implementation of National Health Insurance Coverage for the Elderly in Korea: A Nationwide Database.International journal of environmental research and public health · 2021Article
- Significant Physical and Exercise-Related Variables for Exercise-Centred Lifestyle: Big Data Analysis for Gynaecological Cancer Patients.BioMed research international · 2021Article
- Who Benefits from the Fixed Copayment of Medical and Pharmaceutical Expenditure among the Korean Elderly?International journal of environmental research and public health · 2020Article
- Age Structural Transitions and Copayment Policy Effectiveness: Evidence from Taiwan's National Health Insurance System.International journal of environmental research and public health · 2020Article
- Gender difference in colorectal cancer indicators for exercise interventions: the National Health Insurance Sharing Service-Derived Big Data Analysis.Journal of exercise rehabilitation · 2019Article
- The cross-interaction between global and age-comparative self-rated health on depressive symptoms-considering both the individual and combined effects.BMC psychiatry · 2016Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrivate 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.
methodsWe 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.
resultsAfter 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.
conclusionsOur 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.
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