한시적 비대면 진료(전화상담∙처방) 시행에 따른 효과 평가 연구

Abstract

Background: The government has temporarily allowed telephone consultations for the first time since February 2020 to prevent decreasing in medical use by health-vulnerable groups. As more than a year has passed since the policy was implemented, it is necessary to analyze the current status of telephone consultations and to analyze whether it has empirically been effective in terms of accessibility and medical continuity. Methods: This study analyzed health insurance claim data to examine status of health care providers and patients use for one year after telephone consultations allowed. Secondly, we analyzed policy effectiveness of telephone consultations with DID (Difference-in-Difference) and PSM (Propensity score matching) in order to see the difference between before and after the policy implementation.

Results: The study found 966,918 patients used telephone consultation service and 63.5% of the total patients are older than 60 years of age for one year (2020.2.~2021.2.). In the hypertensive and diabetic patients group, DID results consider the effect of increasing on the medication possession ratio(MPR) was significant, and the effect of increasing on the continuous prescription group ratio was also significant. In the hypertensive group, DID results consider the effect of decreasing on hospitalizations ratio and emergency room visit ratio were significant. however, diabetic group was not shown any significant result in hospitalizations ratio and emergency room visit ratio.

Conclusion: Based on the results, A number of relevant indicators have been shown to have appropriate effects on the main objectives of the policy in the COVID-19. However, beyond the result of the effectiveness of the policy, sustainable policy operation will be possible only when various concerns of the policy are addressed and operational guidelines that can increase the acceptability of patients and providers are applied.