An Analysis on The Characteristics of Hospital Admission and Discharge for Vaginal Delivery and Cesarean Section and Their Medical Expenses - With Special Focus on Health Insurance Review Assesment Data, 2009 to 2011

Abstract

Purpose: Low birth rate is one of the major social problems in Korea. This study is aimed at providing Korea’s birth promotion policy with evidence derived from the analysis of the delivery data available from the Health Insurance Review & Assessment Service (HIRA). Methods: We conducted an analysis on the characteristics of hospital admissions and discharges by types of delivery using the data on claims for deliveries made to HIRA for the period of 2009 to 2011. Results: Of all deliveries analyzed, 64.3% were normal spontaneous vaginal deliveries and 35.7% were deliveries by cesarean section, and among women above the age of 35, the higher the age, the higher the rate of women who had cesarean sections. On average, those who had vaginal delivery were hospitalized for 3.3 days while those who had cesarean section were for 6.7 days. At hospital discharge, 90.1% of those who had vaginal delivery received medicine while 65.4% of those who had cesarean section did so. These findings were never mentioned in the previous studies. 60% of those who had vaginal delivery were prescribed medicine for less than 3 days’ use, while 49.3% of those who had cesarean section were given medicine for the same period. In terms of disease code classification, 83.3% of vaginal deliveries were categorized as single spontaneous delivery (O80), and 49.2% of c-section deliveries were categorized as optional c-section delivery with 35.7% as emergency c-section delivery. 72.7% of vaginal deliveries were included in sub-diagnosis while 82.7% were included for cesarean section. As to the medical expenses incurred, the total medical fee and the co-payment by patients were \828,571 and \16,423 respectively for vaginal delivery and \1,173,769 and \235,522 respectively for cesarean section with the expenses incurred for c-section were \345,198 higher for the total medical fee and \219,099 higher for co-payment than for vaginal delivery. Conclusion: In conclusion, policy efforts should be made to support fertility raising, promotion of vaginal delivery, and child care expansion, for example, a task force or a committee organized by the government.