Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.

<h4>Objectives</h4>There do not appear to be many studies which have examined the socio-economic burden and medical factors influencing the mortality and hospital costs incurred by patients with cardiac arrest in South Korea. We analyzed the differences in characteristics, medical factor...

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Autores principales:	Si Jin Lee, Kap Su Han, Eui Jung Lee, Sung Woo Lee, Myung Ki, Hyeong Sik Ahn, Su Jin Kim
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ea7d6b92794e4453956160cf98e51888
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spelling	oai:doaj.org-article:ea7d6b92794e4453956160cf98e518882021-12-02T20:07:02ZImpact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.1932-620310.1371/journal.pone.0254622https://doaj.org/article/ea7d6b92794e4453956160cf98e518882021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254622https://doaj.org/toc/1932-6203<h4>Objectives</h4>There do not appear to be many studies which have examined the socio-economic burden and medical factors influencing the mortality and hospital costs incurred by patients with cardiac arrest in South Korea. We analyzed the differences in characteristics, medical factors, mortality, and costs between patients with national health insurance and those on a medical aid program.<h4>Methods</h4>We selected patients (≥20 years old) who experienced their first episode of cardiac arrest from 2004 to 2015 using data from the National Health Insurance Service database. We analyzed demographic characteristics, insurance type, urbanization of residential area, comorbidities, treatments, hospital costs, and mortality within 30 days and one year for each group. A multiple regression analysis was used to identify an association between insurance type and outcomes.<h4>Results</h4>Among the 487,442 patients with cardiac arrest, the medical aid group (13.3% of the total) had a higher proportion of females, rural residents, and patients treated in low-level hospitals. The patients in the medical aid group also reported a higher rate of non-shockable conditions; a high Charlson Comorbidity Index; and pre-existing comorbidities, such as hypertension, diabetes mellitus, and renal failure with a lower rate of providing a coronary angiography. The national health insurance group reported a lower one-year mortality rate (91.2%), compared to the medical aid group (94%), and a negative association with one-year mortality (Adjusted OR 0.74, 95% CI 0.71-0.76). While there was no significant difference in short-term costs between the two groups, the medical aid group reported lower long-term costs, despite a higher rate of readmission.<h4>Conclusions</h4>Medical aid coverage was an associated factor for one-year mortality, and may be the result of an insufficient delivery of long-term services as reflected by the lower long-term costs and higher readmission rates. There were differences of characteristics, comorbidities, medical and hospital factors and treatments in two groups. These differences in medical and hospital factors may display discrepancies by type of insurance in the delivery of services, especially in chronic healthcare services.Si Jin LeeKap Su HanEui Jung LeeSung Woo LeeMyung KiHyeong Sik AhnSu Jin KimPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254622 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Si Jin Lee Kap Su Han Eui Jung Lee Sung Woo Lee Myung Ki Hyeong Sik Ahn Su Jin Kim Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.
description	<h4>Objectives</h4>There do not appear to be many studies which have examined the socio-economic burden and medical factors influencing the mortality and hospital costs incurred by patients with cardiac arrest in South Korea. We analyzed the differences in characteristics, medical factors, mortality, and costs between patients with national health insurance and those on a medical aid program.<h4>Methods</h4>We selected patients (≥20 years old) who experienced their first episode of cardiac arrest from 2004 to 2015 using data from the National Health Insurance Service database. We analyzed demographic characteristics, insurance type, urbanization of residential area, comorbidities, treatments, hospital costs, and mortality within 30 days and one year for each group. A multiple regression analysis was used to identify an association between insurance type and outcomes.<h4>Results</h4>Among the 487,442 patients with cardiac arrest, the medical aid group (13.3% of the total) had a higher proportion of females, rural residents, and patients treated in low-level hospitals. The patients in the medical aid group also reported a higher rate of non-shockable conditions; a high Charlson Comorbidity Index; and pre-existing comorbidities, such as hypertension, diabetes mellitus, and renal failure with a lower rate of providing a coronary angiography. The national health insurance group reported a lower one-year mortality rate (91.2%), compared to the medical aid group (94%), and a negative association with one-year mortality (Adjusted OR 0.74, 95% CI 0.71-0.76). While there was no significant difference in short-term costs between the two groups, the medical aid group reported lower long-term costs, despite a higher rate of readmission.<h4>Conclusions</h4>Medical aid coverage was an associated factor for one-year mortality, and may be the result of an insufficient delivery of long-term services as reflected by the lower long-term costs and higher readmission rates. There were differences of characteristics, comorbidities, medical and hospital factors and treatments in two groups. These differences in medical and hospital factors may display discrepancies by type of insurance in the delivery of services, especially in chronic healthcare services.
format	article
author	Si Jin Lee Kap Su Han Eui Jung Lee Sung Woo Lee Myung Ki Hyeong Sik Ahn Su Jin Kim
author_facet	Si Jin Lee Kap Su Han Eui Jung Lee Sung Woo Lee Myung Ki Hyeong Sik Ahn Su Jin Kim
author_sort	Si Jin Lee
title	Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.
title_short	Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.
title_full	Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.
title_fullStr	Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.
title_full_unstemmed	Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.
title_sort	impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: a nation-wide population-based study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ea7d6b92794e4453956160cf98e51888
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Impact of insurance type on outcomes in cardiac arrest patients from 2004 to 2015: A nation-wide population-based study.

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