A comparative study on the obstetric services utilization by income classes among the National Health Insurance Beneficiaries

Abstract

ObjectiveThis study was conducted to compare the trend of obstetrical care service and its performance, different kinds of common obstetrical disease, and different pattern of health care utilization by the classification of income among the National Health Insurance Beneficiaries. MethodsThis study was investigated on the base of data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium from 2004 to 2008. Subjects were divided into five income classes by the amount of medical insurance premium. Statistical analysis was performed using SAS program. ResultsIn terms of the lowest income class, there was the lowest rate of admission but the highest rate of outpatient visits, which were remarkably increased during the last 2 years. The lowest income group showed higher rate of abortion (O00−O08), ectopic pregnancy and preeclampsia (O10−O16) but there was small number of delivery (O80−O84). The highest income group showed higher rate of multifetal gestation and elderly gravida. As they have higher income, they showed tendency to visit general hospital for admission care or outpatient care. ConclusionThere were significant differences in obstetric services utilization and prevalence of common obstetrical disease according to income class. New strategy of public medical insurance is needed to support different disease category according to the socioeconomic status. Especially, institutional support should be considered for lower income women who are exposed to higher pregnancy complications.