Equity in the Delivery of Health care in the Republic of Korea

의료이용의 형평성에 관한 실증적 연구 -공.교 의료보험 피부양자를 대상으로-

  • 명지영 (서울대학교 보건대학원) ;
  • 문옥륜 (서울대학교 보건대학원)
  • Published : 1995.12.01

Abstract

This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.

Keywords

References

  1. 인구보건논집 v.5 no.2 지역의료보험의 의료이용도 및 소득재분배효과에 관한 분석 김기옥;이규식
  2. 서울대학교 보건대학원 석사학위논문 의료이용에 영향을 미치는 요인에 관한 분석 배상수
  3. 보건행정학회지 v.2 no.1 지역의료보험의 실시에 따른 의료이용변화분석 배상수
  4. 우리나라 의료요구 및 의료이용에 관한 조사연구보고 송건용;김흥숙
  5. 의료보험 의료보험과 형평성의 문제 양봉민
  6. 예방의학회지 v.20 no.2 도시지역주민의 의료이용양상과 그 결정요인 유승흠;조우현;박종연;이명균
  7. 한국사회와 의료보장정책 문옥륜
  8. 인구보건논집 v.8 no.1 의료보험이 의료이용양상과 의료균점에 준 효과 분석 송건용;박연우
  9. 동국대학교 행정대학원 복지행정학과석사학위논문 한국의료보장의 불평등에 관한 연구 송충근
  10. 보건학논집 v.32 소득계층별 보험의료이용도 및 보험료 전이에 관한 연구 전혜련;문옥륜
  11. Journal of Health Economics v.11 Access, Utilisation and equity : A further comment A.J.Culyer
  12. Journal of Health Economics v.12 Equity and equality in health and health care A.J.Culyer
  13. Journal of Health Economics v.10 Horizontal equity in the delivery of health care Adam Wagstaff
  14. Equity in health service Health service distribution and equity Anderson,R.;R.Anderson(ed.);J.Kravits(ed.);O.Anderson(ed.)
  15. Equity in health services Utilization physician services across income groups, 1963-1970 Benham,L.;Benham,A.;R.Anderson(ed.);J.Kravits(ed.);O.Anderson(ed.)