노인장기요양보험제도가 노인진료비에 미치는 영향

Abstract

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing long-term care insurance system. The study period was 2 years before and after introduction of the system.Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple re-gression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were de-mographic variables, economic status, diseases, and medical examination variables.Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multi-ple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant.Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.Keywords: Long-term care insurance; Medical expenditures for the elderly; Difference-in-difference analysis