Journal List > Korean J Obstet Gynecol > v.55(11) > 1088543

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Kim, Hwang, Yoon, Ryu, and Hong: A comparative study on the obstetric services utilization by income classes among the National Health Insurance Beneficiaries
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2012; 55(11): 804-813.

Published online: 16 November 2012

DOI: https://doi.org/10.5468/KJOG.2012.55.11.804

A comparative study on the obstetric services utilization by income classes among the National Health Insurance Beneficiaries

Kyung Ha Kim, PhD1, Rah Il Hwang, PhD2, Ji Won Yoon, PhD2, Ki-Jin Ryu, MD3, Soon-Cheol Hong, MD, PhD3

1Worker's Compensation Research Center, Korea Worker's Compensation and Welfare Service, Seoul, Korea.

2Department of Nursing, Suwon Women's College, Suwon, Korea.

3Department of Obstetrics and Gynecology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.

Corresponding authors: Rah Il Hwang, PhD. Department of Nursing, Suwon Women's College, 72 Onjeong-ro, Gwonseon-gu, Suwon 441-748, Korea. Tel: +82-31-290-8103, Fax: +82-31-290-8142, hwangri@swc.ac.kr, Soon-Cheol Hong, MD, PhD. Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-2-920-6602, Fax: +82-2-921-5357, novak082@korea.ac.kr

Received 4 May 2012       Revised 24 August 2012       Accepted 10 October 2012

Copyright © 2012. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

This study was conducted to compare the trend of obstetrical care service and its performance, different kinds of common obstetrical disease, and different pattern of health care utilization by the classification of income among the National Health Insurance Beneficiaries.

Methods

This study was investigated on the base of data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium from 2004 to 2008. Subjects were divided into five income classes by the amount of medical insurance premium. Statistical analysis was performed using SAS program.

Results

In terms of the lowest income class, there was the lowest rate of admission but the highest rate of outpatient visits, which were remarkably increased during the last 2 years. The lowest income group showed higher rate of abortion (O00-O08), ectopic pregnancy and preeclampsia (O10-O16) but there was small number of delivery (O80-O84). The highest income group showed higher rate of multifetal gestation and elderly gravida. As they have higher income, they showed tendency to visit general hospital for admission care or outpatient care.

Conclusion

There were significant differences in obstetric services utilization and prevalence of common obstetrical disease according to income class. New strategy of public medical insurance is needed to support different disease category according to the socioeconomic status. Especially, institutional support should be considered for lower income women who are exposed to higher pregnancy complications.

Keywords: Income class, Obstetric outcomes, Abortion, Preeclampsia, Multifetal gestation

Figures and Tables

Table 1
Change in obstetrical care services by income classes
kjog-55-804-i001

Unit, person; day; million won; %.

Table 2
Obstetrical care services by income classes and classification of disease categories
kjog-55-804-i002

Unit, person; day; million won; %.

Table 3
Obstetrical care service compared by the income classes and the patient characteristics
kjog-55-804-i003

Unit, Person, %; In, in-patients; Out, out-patients.

Table 4
Number of patients of frequency diseases by the income classes
kjog-55-804-i004

Unit, persons per 1,000.

Table 5
Obstetrical care services utilizations by income classes and medical institutions
kjog-55-804-i005

Unit, Person; Day; %.

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