Does long-term care insurance reduce the burden of medical costs? A retrospective elderly cohort study

Aim To examine whether long-term care insurance (LTCI) reduces medical utilization and the burden of medical costs of beneficiaries. Methods The elderly cohort database of the National Health Insurance Service during 2005-2013 was used. The participants were 3029 beneficiaries who received consecutive LTCI services. We carried out a 1:3 case-control match on the propensity score to select a comparison group, and the final participants were 12 116 people, including 9087 who formed the control group. The dependent variables were semi-annually measured medical utilizations (inpatient, outpatient and drug prescription) and the burden of medical costs at the individual level. This study applied the method of generalized estimating equations to the data. Results The present study showed that the number of hospitalizations of beneficiaries significantly decreased compared with non-beneficiaries (ratio 0.95, 95% CI 0.95-0.96). Similarly, the length of stay of beneficiaries also showed a significant reduction compared with non-beneficiaries (ratio 0.76, 95% CI 0.73-0.79). The number of outpatient visits and receipt of drug prescriptions of beneficiaries and non-beneficiaries increased marginally. The burden of medical costs of beneficiaries reduced considerably compared with non-beneficiaries (ratio 0.80, 95% CI 0.77-0.83). Conclusions The study results show that the burden of medical costs for LTCI beneficiaries were significantly reduced compared with non-beneficiaries, despite the rise in medical costs among older adults. The positive effect of LTCI supports continuous implementation and expansion of the LTCI service for non-beneficiaries who require care assistance. Geriatr Gerontol Int 2018; 18: 1641-1646.