Effectiveness of Case Management for High-Frequency Outpatients and Long-Term Inpatients Among South Korean Medical Aid Beneficiaries

초록

Background/Objectives: South Korea implemented a case management program for Medical Aid (MA) beneficiaries in 2003. This study evaluates the effect of case management on healthcare utilization among MA beneficiaries, with a focus on both outpatients and inpatients. Methods: This retrospective comparative study was conducted using the 2023 full dataset of MA beneficiaries. The propensity score matching method was used to match the case management group with the non-case management group, and differences in healthcare utilization were analyzed using a difference-in-differences analysis. Results: The case management group exhibited characteristics of a medically vulnerable population, with greater healthcare needs than those of the non-case management group. Case management interventions reduced outpatient days by 4.7 and outpatient medical costs by USD 327 per person annually. For long-term inpatients, it reduced inpatient days by 13.6 and medical costs by USD 2261 per person annually (p < 0.001). Conclusions: MA case management effectively reduced both outpatient/inpatient days and medical costs. As the effects may vary depending on the type of case management, developing diverse and detailed case management programs is necessary.

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