노인장기요양 등급 및 급여 특성이 의료이용에 미치는 영향

• Published in: Health policy and management Vol. 33; no. 3; pp. 295 - 310
• Main Authors: 손강주, Kang Ju Son, 오성진, Seung-jin Oh, 윤종민, Jong-min Yoon
• Format: Journal Article
• Language: Korean
• Published: 한국보건행정학회 30.09.2023
• Subjects: Linear mixed model; Long-term care; Longitudinal logit model; Medical institution classification; Medical service; Medical usage; Repeated measures analysis; Longitudinal logit model; Linear mixed model; Repeated measures analysis; Medical usage; Long-term care; Medical service; Medical institution classification
• ISSN: 1225-4266

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.