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Disagreement between a public insurer’s recommendation and beneficiary’s choice of long-term care services in Korea

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  • Song, Misook
  • Song, Hyunjong

Abstract

This study examined the disagreement between an insurer’s recommendation for long-term care (LTC) services and beneficiaries’ choices and analyzed the factors associated with the disagreement. Data from the National Long-Term Care Insurance (LTCI) and the Standard Care Plan were merged to create a dataset of 43,319 LTCI beneficiaries. The dependent variable was the disagreement between beneficiaries and insurers. Predisposing, enabling, and needs factors were independent variables based on the Andersen’s Model. Disagreement between the insurer’s recommendation of home care services and the beneficiaries’ choice of institution service was 6.7% (n = 2357). The opposite disagreement occurred in 23.0% (n = 1820) of cases. A multivariate analysis showed that the OR for disagreement between insurer-recommended home care services and beneficiary-selected institution services increased with age, living with someone, having Medical Aid, living in a facility, and having high care needs, dementia, and poor subjective hearing. The OR for disagreement between insurer-recommended institution service and beneficiary-selected home care service increased for men and decreased for those 90 years or older, living with someone, having Medicaid etc, and living at institution. Korean beneficiaries of LTCI have a high preference for aging in their home, and changes in LTCI contents must be made to address the needs of this population.

Suggested Citation

  • Song, Misook & Song, Hyunjong, 2020. "Disagreement between a public insurer’s recommendation and beneficiary’s choice of long-term care services in Korea," Health Policy, Elsevier, vol. 124(8), pages 881-887.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:8:p:881-887
    DOI: 10.1016/j.healthpol.2020.04.012
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    References listed on IDEAS

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    1. Hsu, Hui-Chuan & Chen, Chen-Fen, 2019. "LTC 2.0: The 2017 reform of home- and community-based long-term care in Taiwan," Health Policy, Elsevier, vol. 123(10), pages 912-916.
    2. Sugawara, Shinya & Nakamura, Jiro, 2016. "Gatekeeper incentives and demand inducement: An empirical analysis of care managers in the Japanese long-term care insurance program," Journal of the Japanese and International Economies, Elsevier, vol. 40(C), pages 1-16.
    3. Terry Y. S. Lum & Vivian W. Q. Lou & Yanyan Chen & Gloria H. Y. Wong & Hao Luo & Tracy L. W. Tong, 2016. "Neighborhood Support and Aging-in-Place Preference Among Low-Income Elderly Chinese City-Dwellers," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 71(1), pages 98-105.
    4. Peter Alders & Hannie C. Comijs & Dorly J. H. Deeg, 2017. "Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996–1999 and 2006–2009," European Journal of Ageing, Springer, vol. 14(2), pages 123-131, June.
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    Cited by:

    1. Shi, Hon-Yi & Yeh, Shu-Chuan Jennifer & Chou, Hsueh-Chih & Wang, Wen Chun, 2023. "Long-term care insurance purchase decisions of registered nurses: Deep learning versus logistic regression models," Health Policy, Elsevier, vol. 129(C).

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