Having a Physician Rather than a Place as a Usual Source of Care Would Be Better - from 2012 Korea Health Panel Data

Abstract

A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC. Adjusted odds ratios (ORs) of having a physician with a place compared to not having a USC were 4.05 for age 65 ≥ years (vs. < 35 years), 1.33 for females (vs. males), 0.63 for the fifth (highest) quintile (vs. the first) of household income, 1.62 for medical aid (vs. employee) health insurance, and 4.46 for having a chronic disease (vs. not). For those having a physician with a place (vs. only a place) as a USC, adjusted ORs of hospital admission and emergency room (ER) visit were 0.77 and 0.71 with out-of-pocket costs not significantly high. Those having a physician with a place (vs. only a place) as a USC included more patients with chronic diseases, but they had fewer hospital admissions and ER visits. When designing a plan for health care reform in Korea, promoting having a physician rather than a place as a USC would be a better policy.

Emergency Department Visits Can Be Reduced by Having a Regular Doctor for Adults with Diabetes Mellitus: Secondary Analysis of 2013 Korea Health Panel Data

“…Fourth, among diabetic adults, four features of RD were associated with less likely to have an experience of ED visits within the last year: having a RD (OR, 0.65; 95% CI, 0.35–0.94), having a RD delivering a good comprehensiveness of care (OR, 0.47; 95% CI, 0.26–0.84), having a RD of primary care practice (OR, 0.43; 95% CI, 0.22–0.81), and having a RD who had a longitudinal relationship with the diabetic adults of 5 years or less (OR, 0.45; 95% CI, 0.22–0.91). Fifth, having a RD would be better than having a place only as a USC to less likely have an experience of ED visits in diabetic adults (OR, 0.52; 95% CI, 0.29–0.92) and in the general adult population (OR, 0.71; 95% CI, 0.55–0.93) as reported previously ( 29 ).…”

Primary Care Comprehensiveness Can Reduce Emergency Department Visits and Hospitalization in People with Hypertension in South Korea

“…Having a USC for hypertensive patients was associated with a higher percentage use of anti-hypertensive medication and better control of blood pressure [ 6 , 7 , 8 , 9 ]. Identification of a particular practitioner of care (a usual physician) has particularly been associated with better services, such as better recognition of problems or needs, more accurate or earlier diagnoses, a lower rate of emergency department use, fewer hospitalizations, lower costs, better monitoring, fewer drug prescriptions, fewer unmet needs, and increased satisfaction than mere identification of a particular place of care (a usual place only) [ 10 , 11 , 12 , 13 ].…”

The Effect of Usual Source of Care on the Association of Annual Healthcare Expenditure with Patients’ Age and Chronic Disease Duration

“…However, the moderating effect of having a regular site increased CDM cost for elderly, which might be optimistically interpreted as short-term increases because of periodic visits for prevention and management. This result is supported by a study that having a regular site for primary care increased more OOP costs than not having USOC [ 23 ]. In addition, even though total healthcare costs of elderly was not significantly affected by having a regular site, it represented a decreasing direction, indicated by a negative coefficients.…”