Expansion of Health Insurance Coverage for Prenatal Care and Its Association with Low Birth Weight and Premature Birth

Abstract

Purpose The purpose of this study was to investigate the relationship between the cost of medical care for pregnancy and childbirth and the birth outcome. Methods Using the Korean National Health Insurance Corporation cohort data, we compared the birth outcome of 2,198 subjects before policy (2005-2008) and after policy (2009-2012) costs related to pregnancy and childbirth. Results After the rate of application of the maternity care fee increased by 2.3%, the cesarean section rate increased by 15%. The incidence of low birth weight was significantly lower in women under 35 years of age, as well as in women over 35 years of age who had delivered a child through cesarean section. Conclusion After the policy implementation, the rates of low birth weight and premature childbirth decreased at all ages, for second or subsequent births. Considering the purpose of the pregnancy and childbirth care support policy, implemented to reduce the burden of medical expenses and to create a favorable environment for childbirth, it is necessary to expand coverage by converting nonpayment items, and to develop diverse and comprehensive policies that consider pregnant women’s characteristics. Key Words: Health policy, Program evaluation, Prenatal care, Low birth weight, Premature birth