Case management for medical aid beneficiaries in Korea: findings from case-control study.

PURPOSE: This study was to evaluate effects of case management provided for 7 months for medical aid in Korea. METHODS: This study was a retrospective comparative study using secondary data analysis. Data from two pre-existing survey were reanalyzed. The data were collected through door to-door interviews using the structured questionnaire. For the medical service use, claims data from the Korea National Health Insurance Corporation was used. Subjects were 73 in the intervention group and 118 in the control group. RESULTS: There was no significant change in the intervention group in self-care ability (p = .296), medication adherence (p = .194) or quality of life (p = .903) compared to those of the control group. For hospital visiting days, it appeared to decrease in the intervention group (p = .038) but with no significant difference from that of the control group (p = .157). Neither were there significant differences in medical expenditures (p = .605). CONCLUSION: Although the effect of case management in this study appeared extremely limited, the short intervention period and characteristics of the medical aid beneficiaries and the limit of controlling only the demand side were discussed as factors to be considered. Nurses have been carrying out professional roles in case management in Korea. However more efforts are needed to develop case management as an area for nursing specialization.

Success of case management for medical aid initiative in Korea.

The purpose of this cross-sectional study was to determine the effects of case management of Korea Medical Aid on recipients' satisfaction, ability to handle health problems, health behaviour, quality of life (QoL), hospital visiting days and medical expenditure. Data from structured interviews and claim data from medical institutions to the Korea National Health Insurance Corporation were used. Survey data were collected by questionnaire during September 2008. There were 647 responses out of 1069 (response rate 60.5%), but 260 were excluded from the analyses in this paper because they had received case management for <18 months. This left 269 individuals who had received case management services for 18 months continuously and 118 who had received no case management services in the same time period. Among the former group, 86.9% were satisfied or strongly satisfied with the initiative. Results indicate that the satisfaction for the case management was very high. Although there was no difference in terms of health behaviour and QoL between the two groups, the overall ability to handle health problems was higher in the case management group (P < 0.001). As for healthcare use, the programme produced a significant reduction in hospital visiting days (P = 0.034), and while the mean increase in cost from 2007 to 2008 was 29.1% lower for individuals in the programme, the difference between the groups was not significant (P = 0.851). Case management in Korea is in its early stages, and efforts should be made to extend this approach.