노인장기요양보험 서비스 이용에 따른 의료이용 및 의료비 지출 양상의 변화

Abstract

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC)implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selectedwho had a new LTC grade (grade 1–5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmentedregression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medicalcosts. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, anddementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementationand then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTCimplementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter,changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level changewas decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries wouldimprove their quality of life by adequately resolving their medical needs by their grades.