Health Policy Manag.  2024 Sep;34(3):249-260. 10.4332/KJHPA.2024.34.3.249.

Changes in National Health Insurance Medical Expenses and Long-Term Care Costs between the Long-Term Care Group and General Older Adults Group before and after Long-Term Care Use

• Oh SJ
• Son KJ

• KMID: 2562582
• DOI: http://doi.org/10.4332/KJHPA.2024.34.3.249

Abstract

Background
The Republic of Korea’s aging population escalates medical and long-term care costs. While prior research has suggested that long-term care might reduce these costs, these studies had limitations in their subjects and duration, making it difficult to generalize the results. This study aims to evaluate cost changes between the long-term care group and the general older adults group after addressing these limitations.
Methods
A cohort was derived from the 2015 national population using stratified sampling. Subsequently, 15,114 individuals (7,557 in each group) were identified through 1:1 propensity score matching. The study employed a difference-in-differences analysis to explore variances in medical costs and long-term care benefits post-utilization of long-term care services.
Results
Compared to the general older adults group, the long-term care group experienced a reduction in monthly per capita total medical costs by 56,459 Korean won (KRW). Although costs at tertiary and general hospitals increased, those related to long-term care hospitals decreased by 90,687 KRW. Including long-term care benefits, overall expenditures increased by 948,038 KRW.
Conclusion
The analysis reveals that the long-term care group faces higher medical costs in acute care than the general older adults group, emphasizing a greater need for medical services within this group. To meet the increasing medical demands of the long-term care group, a collaborative strategy linking community resources, healthcare, and long-term care facilities is imperative. Additionally, developing and implementing preventive health habit management strategies for middle-aged and older adults is essential to diminish the future requirement for long-term care.

Keyword

Long-term care insurance; Propensity score matching; Difference-in-differences analysis; Medical cost; Long-term care cost