건강보험 코호트 자료를 활용한 충청남도 지역 환자의 특성에따른 관외 의료이용과의 연관성

Abstract

Background: The purpose of this study was to investigate the association between external medical service use and the characteristics ofChungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system inChungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016–2019, and 2,570,439 patients were included in the study. Multivariate logisticregression and multinomial logistic regression were used to identify the association between external medical service use and each patientcharacteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. Incomparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931)demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expensesincurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%)and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should beconducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. Thestudy’s findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuringthe efficient delivery of medical care, and localization of medical care.