Trends in private caregiving cost after implementing a comprehensive nursing service covered by national health insurance: Interrupted time series

Abstract

BackgroundThe Korean government has implemented a comprehensive nursing care service system (CNS) to mitigate the stress faced by caregivers. ObjectiveThis study aimed to assess trends in the estimated average costs of private caregiving and determine the difference in costs between those using CNS and those not using it. DesignA comparative interrupted time series analysis with a 2-year lag period verified total private caregiving cost trends; biannual differences in costs were evaluated based on using CNS. ParticipantsThe main unit of analysis was episode. We extracted a total of 6418 episodes of hospitalization in acute care settings that included the use of caregiving services (formal, informal caregiving and CNS). MethodsWe conducted segmented regression to assess the impact of CNS on total private caregiving costs using data from 2012 to 2018, excluding the years 2015 and 2016 of the Korean Health Panel dataset. ResultsWe presented that the immediate mean difference in total private caregiving costs between CNS users and non-users was −444.7 USD two years after the implementation of the CNS policy (95 % CI −714.5 to −174.5, p-value 0.001). Among individuals living in rural areas, two years after the implementation of the CNS policy, there was a significant immediate mean cost difference of −476.9 USD in total private caregiving costs between CNS users and non-users (p-value 0.011). Similarly, for episodes with a Charlson Comorbidity Index (CCI) score of 0 to 1, there was a substantial immediate mean cost difference in total private caregiving costs between CNS users and non-users, amounting to −399.9 USD two years after the CNS policy (p-value 0.008). ConclusionsThis study evaluated the trend of total private caregiving costs between groups using and not using CNS. After two years of being covered by CNS health insurance, those who utilized CNS paid $433 less for their total private caregiving cost over a 6-month period, compared to those who did not use CNS. The adoption of CNS may be an effective system for relieving the financial burden on inpatients in need of private caregiving services. Tweetable abstractKorean Comprehensive Nursing Service reduces private caregiving costs