Exploring the Healthcare Seeking Behavior of Medical Aid Beneficiaries Who Overutilize Healthcare Services: A Qualitative Descriptive Study.

Jeonghyun Cho,Hyejin Kim,Kyungin Jeong,Samsook Kim

doi:10.3390/ijerph16142485

Abstract

We explored the healthcare seeking behavior of Medical Aid (MA) beneficiaries who over-utilize healthcare services in South Korea. We employed a qualitative descriptive study using semi-structured interviews with fifteen community-dwelling MA beneficiaries—who were categorized as over-utilizing healthcare services—and conventional content analysis. Four categories emerged: having unmet healthcare needs, wandering in search of effective healthcare services, routinizing their use of healthcare services, and being concerned about benefit restrictions due to their healthcare overutilization. Overall, these categories indicate participants’ behaviors used to fill the gap between their high healthcare needs and restricted MA benefits. The findings provide a foundation for healthcare providers, policymakers, researchers, and MA beneficiaries to discuss how to better address beneficiaries’ healthcare needs while preventing healthcare overutilization patterns. Effective and innovative interventions that target MA beneficiaries and their case managers are necessary to improve beneficiaries’ quality of life.

Highlights

Since 1977, the Medical Aid (MA) program has been operated by the government in South Korea as a national public assistance program for low-income people who are impoverished or unable to sustain their livelihoods on their own [1]
We reported all procedures and findings using the consolidated criteria for reporting qualitative research (COREQ) [11]
Fifteen MA beneficiaries participated in this study

Summary

Introduction

Since 1977, the Medical Aid (MA) program has been operated by the government in South Korea as a national public assistance program for low-income people who are impoverished or unable to sustain their livelihoods on their own [1]. It provides minimum medical security for low-income families [2], which is similar to Medicaid in the U.S, the National Health Service Low Income Scheme in U.K., and the medical assistance program (i.e., Hilfen zur Gesundheit) in Germany [3].

Objectives

Methods

Results

Discussion

Conclusion