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The purpose of this study was to determine whether the introduction of diagnosis-related groups (DRGs) shifted the medical services from inpatient to outpatient settings. Using a difference-in-difference analysis, the changes in length of stay, outpatient visit days within 30 days before hospitalization, and outpatient visit days within 30 days after hospital discharge were evaluated. The length of stay was reduced after the DRG policy, consistent with previous studies. Outpatient visit days within 30 days before a hospital admission increased significantly after the policy change. In addition, outpatient visit days within 30 days after a hospital discharge increased in all the medical institutions excluding hospitals. The study findings are consistent with the expectation that providers respond to changes in the payment system to protect or enhance their economic interests. Health care providers in Korea responded to the DRG policy by reducing the intensity of inpatient treatment and transferring costs to outpatient settings. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between economic status and mortality of Korean men and women who were under and over the average national life expectancy using Cox’s proportional hazard model to adjust for health status, past medical history, and age. The study subjects come from local applicants of Korean National Health Insurance who had a health examination in 2005. They were enrolled into a follow-up investigation from 2005 to 2011. In individuals younger than the average life expectancy, the mortality of the lowest economic status was 2.48 times higher in men and 2.02 times higher in women than that in the highest economic status. Economic status–mortality association in males older than the average life expectancy was attenuated but not eliminated. However, there is no significant relationship between economic status and mortality for females above the average life expectancy. [ABSTRACT FROM PUBLISHER]