J Korean Med Sci.  2017 Jan;32(1):4-12. 10.3346/jkms.2017.32.1.4.

Having a Physician Rather than a Place as a Usual Source of Care Would Be Better - from 2012 Korea Health Panel Data

• Kim KM
• Jeon H
• Lee JH

• KMID: 2417578
• DOI: http://doi.org/10.3346/jkms.2017.32.1.4

Abstract

A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC. Adjusted odds ratios (ORs) of having a physician with a place compared to not having a USC were 4.05 for age 65 ≥ years (vs. < 35 years), 1.33 for females (vs. males), 0.63 for the fifth (highest) quintile (vs. the first) of household income, 1.62 for medical aid (vs. employee) health insurance, and 4.46 for having a chronic disease (vs. not). For those having a physician with a place (vs. only a place) as a USC, adjusted ORs of hospital admission and emergency room (ER) visit were 0.77 and 0.71 with out-of-pocket costs not significantly high. Those having a physician with a place (vs. only a place) as a USC included more patients with chronic diseases, but they had fewer hospital admissions and ER visits. When designing a plan for health care reform in Korea, promoting having a physician rather than a place as a USC would be a better policy.

Keyword

Primary Health Care; Health Policy; Korea; Surveys and Questionnaires

MeSH Terms

Adult
Chronic Disease
Emergency Service, Hospital
Family Characteristics
Female
Health Care Reform
Health Expenditures
Health Policy
Humans
Insurance, Health
Korea*
Odds Ratio
Outpatients
Primary Health Care
Quality of Health Care
Surveys and Questionnaires

Figure

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  Fig. 1 Sample selection process from the 2012 KHP data. KHP = Korea Health Panel, USC = usual source of care.

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