Individuals who have previously filed claims for private medical insurance not only visit hospitals more frequently but also spend more on outpatient care compared to those who haven’t filed claims. (Image courtesy of Yonhap)
SEOUL, Jan. 9 (Korea Bizwire) — A new study has revealed that individuals who have previously filed claims for private medical insurance not only visit hospitals more frequently but also spend more on outpatient care compared to those who haven’t filed claims.
According to research published in the recent issue of the Korean Journal of Hospital Management, a team led by professor Choi Mankyu of Korea University’s College of Health Science analyzed the impact of insurance claim experience on outpatient medical service utilization.
The researchers examined data from the Korea Health Panel, focusing on 3,707 individuals who maintained private health insurance coverage in both 2019 and 2020. They compared the 2020 outpatient usage patterns between two groups: 509 people (13.73%) who had filed insurance claims in 2019 and 3,198 people (86.27%) who had not.
The findings showed that policyholders with prior claim experience averaged 17.84 outpatient visits, significantly higher than the 11.81 visits averaged by those who had never filed claims. The difference in outpatient medical expenses was also substantial, with experienced claimants spending 841,386 won compared to 522,350 won for those without claim experience.
Further analysis revealed that individuals with previous claim experience were 2.86 times more likely to use outpatient services and spent 43.3% more on medical expenses compared to those without claim experience.
The research team explained that these findings demonstrate how familiarity with the insurance claim process can lead to more proactive use of outpatient services, ultimately resulting in increased medical visits and expenses.
“We confirmed a significant correlation between insurance claim experience and increases in both outpatient payments and visit frequency,” the research team stated. The researchers recommended strengthening regulations against excessive medical service use, noting that “as insurance holders become less sensitive to costs due to reduced financial burden, we need to prevent unnecessary medical consumption.”
M. H. Lee (mhlee@koreabizwire.com)
