Journal of Preventive Medicine and Public Health

  • 제40권4호
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  • Pages.329-335
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  • 2007
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
권호 표지

민간의료보험이 암 환자의 의료이용과 의료비에 미치는 영향: 일개 암전문의료기관의 우리나라 주요 암종을 중심으로

Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center

  • 임진화 (국립암센터 국가암관리사업단) ;
  • 최귀선 (국립암센터 국가암관리사업단) ;
  • 김성경 (국립암센터 국가암관리사업단) ;
  • 박은철 (국립암센터 국가암관리사업단) ;
  • 박재현 (국립암센터 국가암관리사업단)
  • Lim, Jin-Hwa (National Cancer Control Research Institute, National Cancer Center) ;
  • Choi, Kui-Son (National Cancer Control Research Institute, National Cancer Center) ;
  • Kim, Sung-Gyeong (National Cancer Control Research Institute, National Cancer Center) ;
  • Park, Eun-Cheol (National Cancer Control Research Institute, National Cancer Center) ;
  • Park, Jae-Hyun (National Cancer Control Research Institute, National Cancer Center)
  • 발행 : 2007.07.31
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초록

Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

키워드

참고문헌

  1. Korea Insurance Development Institute. Risk Management of Private Health Insurance, CEO Report. Seoul: Korea Insurance Development Institute; 2005. p. 1-2 (Korean)
  2. Kim SO. Risk Selection of Private Health Insurance and Medical Care Utilization. Seoul: The 6th Korea Labor Panel Journal; 2005. p. 2131 (Korean)
  3. Jung KT. Trends of Private Health Insurance Market and Related Policy Issues. Seoul: Property Insurance; 2005: p. 7-17 (Korean)
  4. National Health Insurance Coporation. [cited 2007 March 4]. Available from: URL: http://www.nhic.or.kr/wbm/wbmc/wbmc_0400/wbmc_0401/wbmc_0401.html
  5. 건보 재정흑자, 저소득 암환자에 써라. 한국일보 2005년 4월 27일자 [cited 2007 May 27] Available from: URL:http://news.hankooki . com/lpage/society/200504/h2005042718194621950.htm
  6. Korea National Statistical Office. Death registry data. Korea National Statistical Office; 2006 [cited 2007 March 7]. Available from: URL http://www.nso.go.kr/nso2006/k04_0000/k04g_0000/k04gb_0000/k04gbc0000/k04gbc0080/k04gbc0080.html (Korean)
  7. Ministry of Health & Welfare. Cancer Incidence in Korea 1999-2001. Ministry of Health & Welfare; 2006 [cited 2007 March 11]. Available from: URL: http://www.cancer.go.kr/ nciapps/user/stat/view .jsp ?seq=33&sta_ base year=&sta_gubun=¤tPage=2&sValue=&cancer_cmd=ALLNANNANNAN&sChk=&ke yword=&tmp_keyword=&sCatgType 1=(Korean)
  8. Yang BM. Health Economics. Seoul: Nanam Pub. Co; 1999.p.145-146(Korean)
  9. Park HM, Kim KH. Expanding the Role of Private Health Insurance in Health Insurance. Seoul: Korea Insurance Development Institute; 2001. p. 59-61 (Korean)
  10. Kang SW, Kwon YD, You CH. Effects of supplemental insurance on health care utilization and expenditures among cancer patients in Korea. Korean J Health Policy Admin 2005; 15(4): 65-80 (Korean) https://doi.org/10.4332/KJHPA.2005.15.4.065
  11. OECD. Private health insurance in OECD countries. Paris: OECD Publishing; 2004. p. 35-37
  12. Manning WG, Newhouse JP, Duan N, Keeler EB, Leibowitz A, Marquis MS. Health insurance and the demand for medical care: Evidence from a randomized experiment. Am Econ Rev 1987; 77(3): 251-277
  13. Long SH, Marquis MS. The uninsured 'access gap' and the cost of universal coverage. Health Aff(Millwood) 1994; 13(2): 211-220 https://doi.org/10.1377/hlthaff.13.2.211
  14. Wolfe J, Goddeeris J. Averse selection, moral hazard, and wealth effects in the Medigap insurance market. J Health Econ 1991; 10(4): 433459
  15. Cartwright W, Hu T, Huang L. Impact of varying Medigap insurance coverage on the use of medical services of the elderly. Appl Econ 1992; 24(5): 529-539 https://doi.org/10.1080/00036849200000066
  16. Ettner S. Adverse selection, the purchase of medigap insurance by the elderly. J Health Econ 1997; 16(5): 543-562 https://doi.org/10.1016/S0167-6296(97)00011-8
  17. Hurd MD, McGarry K Medical insurance and the use of health care services by the elderly. J Heolth Econ 1997; 16(2): 129-154 https://doi.org/10.1016/S0167-6296(96)00515-2
  18. Vera-Hernandez AM. Duplicate coverage and demand for health care. The case of Catalonia. Health Econ 1999; 8(7): 579-598 https://doi.org/10.1002/(SICI)1099-1050(199911)8:7<579::AID-HEC478>3.0.CO;2-P
  19. Hanmon C, Nolan B. Health insurance and health services utilization in Ireland. Health Econ 2001; 10(2): 135-145 https://doi.org/10.1002/hec.565
  20. Schellhorn M. The effect of variable health insurance deductibles on the demand for physician visits. Health Econ 2001; 10(5): 441-456 https://doi.org/10.1002/hec.630
  21. Atherly A. The effect of medicare supplemental insurance on medicare expenditures.lnt J Health Care Finance Econ 2002; 2(2): 137-162 https://doi.org/10.1023/A:1019978531869
  22. Sapelli C, Vial B. Self-selection and moral hazard in Chilean health insurance. J Health Econ 2003; 22(3): 459-476 https://doi.org/10.1016/S0167-6296(02)00121-2
  23. Buchmuellera T, Couffinhalb A, Grignonb M, Perronninb M. Access to physician service: does supplemental insurance matter? Evidence from France. Health Econ 2004; 13(7): 669-687 https://doi.org/10.1002/hec.879
  24. Joung KT. Private health insurance development strategy.lnsur dev 1996; 17: 127-149 (Korean)
  25. Kim WS. Balanced development of national health insurance and private health insurance. lnsur dev 2002; 13(3): 111-153 (Korean)
  26. Kang SW, Kwon YD, Kim SA. Effects of private health insurance on hospitals in Korea. Korean J Health Econs Policy 2004; 10(2): 23- 36 (Korean)
  27. Kim WJ. Introduction of private health insurance and related issues. Korean Health assoc 2004; 33(1): 66-74 (Korean)
  28. Choi BH. Healthcare market opening and private health insurance. Policy Forum 2004; 88: 29-41 (Korean)
  29. Gam S. Influence of Health care market liberalization on health insurance structure. Health insur forum 2005; 4(1): 17-30 (Korean)
  30. Lee JS. Privatization of health service and health insurance. Health insur forum 2005; 4(1): 5-16 (Korean)
  31. Oh YS. A Study on new relationship between national and private health insurance. J Insur Stud 2006; 17(1): 103-136 (Korean)
  32. Yoon TH, Hwang IK, Sohn HS, Koh KW, Jeong BG. The determinants of private health insurance purchasing decisions under national health insurance system in Korea : The expanding of private health insurance market, for the better or worse. Korean J Health Policy Admin 2005; 15(4): 161-175 (Korean) https://doi.org/10.4332/KJHPA.2005.15.4.161
  33. Lim JH, Kim SG, Lee EM, Bae SY, Park JH, Choi KS, Hahm MI, Park EC. The determinants of purchasing private health insurance in Korean cancer patients. J Prev Med Public Health 2007; 40(2): 150-154 (Korean) https://doi.org/10.3961/jpmph.2007.40.2.150
  34. Jung KT, Shin EK, Kwak CH. An Empirical study on the relationship between private health insurance and moral hazard. Korean Insur J 2006; 75: 1-25 (Korean)