Health Policy Manag.  2015 Mar;25(1):3-10. 10.4332/KJHPA.2015.25.1.3.

Difference in Healthcare Utilization for Percutaneous Transluminal Coronary Angioplasty Inpatients by Insurance Types: Propensity Score Matching Analysis

• Seo EW
• Lee KS

• KMID: 1967210
• DOI: http://doi.org/10.4332/KJHPA.2015.25.1.3

Abstract

BACKGROUND
Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM).
METHODS
The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM.
RESULTS
Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals.
CONCLUSION
Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.

Keyword

Angioplasty, balloon, coronary; Healthcare utilization; Insurance type; Propensity score matching

MeSH Terms

Angioplasty, Balloon, Coronary*
Comorbidity
Delivery of Health Care*
Health Policy
Hospitals, General
Humans
Inpatients*
Insurance*
Insurance, Health
Length of Stay
National Health Programs
Propensity Score*
Regression Analysis
Tertiary Care Centers