The impact of differential cost sharing of prescription drugs on the use of primary care clinics among patients with hypertension or diabetes

Eunja Park; Daeeun Kim; Sookja Choi

doi:10.1016/j.puhe.2019.05.005

제목: The impact of differential cost sharing of prescription drugs on the use of primary care clinics among patients with hypertension or diabetes

저자: Eunja Park ; Daeeun Kim ; Sookja Choi

키워드: Chronic disease ; Diabetes ; Cost sharing ; Healthcare policy ; Hypertension ; Primary care

발행연도: 2019-08

발행기관: Elsevier

인용정보: Public Helath, vol. 173, pp. 105 - 111

초록: Objectives: Since 2011, the Korean government has implemented differential cost sharing to increase the utilization of primary care clinics for the management of chronic diseases. The objective of this study was to examine the impact of the prescription drug cost-sharing increase on outpatients' selection of the medical care institution. Study design: This was a preepost comparison study. Methods: Participants were 34,842 patients with hypertension and 13,886 patients with type 2 diabetes, who were all newly prescribed. Data were collected via national health insurance system claims. The change in the main medical care institution for disease management before and after the cost sharing policy was analyzed using logistic regression analysis. Results: Nearly 18% of participants with hypertension and 22% of participants with diabetes used tertiary care or general hospital outpatient services before the policy was implemented. After the increased prescription drug coinsurance rate (by 10e20%), the likelihood of selecting primary care clinics or small hospitals was signiﬁcantly higher among patients with hypertension within 1 year (odds ratio [95% conﬁdence interval] ¼ 1.29 [1.19e1.41]) than before. However, the policy effect was not signiﬁcant among patients with diabetes. Conclusions: The cost sharing policy was effective in inducing patients with hypertension to manage their chronic disease in primary care institutions; however, this was not true for patients with diabetes. The assurance of high-quality disease management services and low out-of-pocket expenses may be needed to encourage patients with chronic diseases to use primary care clinics.

Fulltext: https://doi.org/10.1016/j.puhe.2019.05.005

ISSN: 0033-3506

DOI: 10.1016/j.puhe.2019.05.005

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