Impacts of Financial Coverage on Long-Term Outcome of Intensive Care Unit Survivors in South Korea
Yonsei Medical Journal
;
: 976-983, 2019.
Artigo
em Inglês
| WPRIM
| ID: wpr-762034
ABSTRACT
PURPOSE:
The objective of this study was to investigate whether financial coverage by the national insurance system for patients with lower economic conditions can improve their 1-year mortality after intensive care unit (ICU) discharge. MATERIALS ANDMETHODS:
This study, conducted in a single tertiary hospital, used a retrospective cohort design to investigate discharged ICU survivors between January 2012 and December 2016. ICU survivors were classified into two groups according to the National Health Insurance (NHI) system in Korea medical aid program (MAP) group, including people who have difficulty paying their insurance premium or receive medical aid from the government due to a poor economic status; and NHI group consisting of people who receive government subsidy for approximately 2/3 of their medical expenses.RESULTS:
After propensity score (PS) matching, a total of 2495 ICU survivors (1859 in NHI group and 636 in MAP group) were included in the analysis. Stratified Cox regression analysis of PS-matched cohorts showed that 1-year mortality was 1.31-fold higher in MAP group than in NHI group (hazard ratio 1.31, 95% confidence interval, 1.06 to 1.61; p=0.012). According to Kaplan-Meir estimation, MAP group also showed significantly poorer survival probability than NHI group after PS matching (p=0.011).CONCLUSION:
This study showed that 1-year mortality was higher in ICU survivors with low economic status, even if financial coverage was provided by the government. Our result suggests the necessity of a more nuanced and multifaceted approach to policy for ICU survivors with low economic status.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Estudos Retrospectivos
/
Estudos de Coortes
/
Mortalidade
/
Sobreviventes
/
Cuidados Críticos
/
Pontuação de Propensão
/
Centros de Atenção Terciária
/
Financiamento Governamental
/
Seguro
/
Unidades de Terapia Intensiva
Tipo de estudo:
Estudo de etiologia
/
Avaliação Econômica em Saúde
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Yonsei Medical Journal
Ano de publicação:
2019
Tipo de documento:
Artigo
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