Factors Associated With Medical Expenses Among Long-Term Care Insurance Recipients Aged 65 Years or Older in Korea

Abstract

This study examined the factors associated with medical expenses among LTCI (long-term care insurance) recipients in Korea. Secondary data analysis was performed using the 2019 Korea National Health Insurance (KNHI) reimbursement data of I metropolitan city. Data from 52 434 older adults who were LTCI recipients and living in I metropolitan city areas were included. Based on the Andersen healthcare utilization model, the variables included the predisposing (age, sex, and living alone), enabling (health insurance and place of residence), and need factors (disability, LTC grade, use of LTCI services, and participation in health screening). All the predisposing, enabling, and need factors were significant. Older age, higher LTC grade, use of visiting nursing service, admission to an aged care facility, and participation in health screenings were negatively associated with medical expenses. Females, those living alone, non-disabled individuals, medical aid beneficiaries, and rural residents were less likely to incur medical expenses. Appropriate use of LTCI services (e.g., visiting nursing) will help reduce unnecessary medical expenses. Nevertheless, access to health care services for older adults living alone in rural areas must be improved.

Keywords: aged; insurance; long‐term care; medical expenses; visiting nursing.