Medical Care Utilization of Tuberculosis Patients in Private Sector

Kang, Gil Won; Yoon, Seok Jun; Kim, Chang Yup; Shin, Young Soo

Abstract

In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National Federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital(45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of carey. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of care was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area