Patient cost-sharing change was implemented on August 1, 2007, for outpatient care in the clinic setting in Korea from copayment to coinsurance. This study aims to estimate the effect of the policy change on medical care usage and expenditure in older Koreans. By using national health insurance claims data from the Health Insurance Reimbursement Assessment Service, this study analyzed the entire 137 million claims for a total of approximately 4.1 million patients aged 60 to 69 years who had been diagnosed and/or treated for outpatient care in clinics from January 1, 2007, to December 31, 2008. Medical care usage was defined as the proportion of all beneficiaries in each group who visited clinics and the mean number of visit days per beneficiary. Medical care expenditure per visit day was expressed as total costs, reimbursed amount, and patient's out-of-pocket payment. Data on January through June of 2008 were analyzed as compared with the same months of 2007. Raw difference-in-difference and multiple regression analyses were performed. The interaction coefficients, which measured the impact of cost-sharing change, was -0.078 in model 1 and -0.039 in model 2 (P < .0001). In conclusion, a cost-sharing change from copayment to coinsurance reduced medical care usage and expenditure.

Purpose:To develop strategies for research and development (R&D) in nursing service based on the policy direction of government supported R&D in Korea. Methods: This was a descriptive study to develop strategies for promoting R&D in nursing by analyzing investment trends and status quo, policy directions, and implementation of the details of government supported R&D through government reports, websites of relevant agencies and literature reviews. Results: Few nursing experts participated in clinical research on overcoming major diseases and in R&D for well-being and care. Development of nursing topics that meet the direction of government supported R&D were lacking. Insufficient implementation of nursing service R&D in a timely manner equipped with a performance-based system. Few research studies in R&D projects that included research using big data or contributing to developing medical instruments. Finally, an insufficient number of nursing specialists participated on government R&D advisory committees. Conclusion: For nursing service R&D development efforts should be toward quantitative expansion and qualitative improvements by sensitively recognizing policy direction of government supported R&D. The promotional capacity of nursing service R&D must be reinforced through a multidisciplinary approach and collaborative association with other professionals and the inclusion of nurse specialists on government R&D advisory committees.