Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Status and related factors of private health insurance for severely ill patients

중증질환자의 민간의료보험 가입 현황 및 관련요인

  • Kim, Seok-Hwan (Department of healthcare-administration, Seoyeong University)
  • 김석환 (서영대학교 보건의료행정과)
  • Received : 2017.09.18
  • Accepted : 2018.01.05
  • Published : 2018.01.31
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Abstract

This study was conducted to investigate the characteristics of private health insurance subscribers and non-subscribers as they relate to severely ill patients, and to identify the factors of participation. The study was conducted using the National Health and Nutrition Examination Survey for 2015, and data were analyzed using SPSS ver. 23.0. The subjects were 417 patients with severe disease (cancer, heart disease, cerebrovascular disease) over 19 years of age. Crossover analysis was employed to identify differences between the state of private health insurance participation, while binary logistic regression analysis was used to confirm the factors affecting private health insurance subscription. Analysis of the effects of the subjects on the private health insurance participation rate revealed that the social and demographic characteristics were higher in younger individuals regardless of sex, residence, or marital status. Moreover, higher household income, regardless of the education level, was associated with a higher participation rate of health insurance target individuals compared to medical benefit target individuals. The private health insurance participation rate was low and the explaining power was 51.7%, regardless of subjective health awareness and walking practice. Therefore, efforts should be made to improve the living environment and support local governmental programs for the elderly, low income households, socially vulnerable groups with limited activities and groups with limited health behavior. It is also necessary to consider various health policies, such as providing government health education or programs to prevent severe illness.

이 연구의 목적은 중증질환자들을 대상으로 민간의료보험 가입자와 미가입자간의 특성을 파악하고, 가입 요인을 분석하기 위함이다. 연구도구는 2015년도 국민건강영양조사 자료를 이용하였으며, SPSS ver 23.0을 사용하였고, 연구 대상자는 19세 이상 중증질환자(암, 심장질환, 뇌혈관질환) 417명을 선정하였다. 분석방법은 민간의료보험 가입 현황과 차이를 파악하기 위해 교차분석을 실시하였고, 민간의료보험 가입에 미치는 요인을 분석하기 위해 이항 로지스틱 회귀분석을 실시하였다. 분석 결과 사회 인구학적 특성에서는 성별, 거주지, 혼인상태와 관계없이 나이가 젊을수록 높았다. 그리고, 사회 경제적 상태에서는 교육수준과 관계없이 가구소득이 높을수록, 의료급여대상자에 비하여 건강보험대상자의 가입률이 높았다. 건강행태에서는 주관적 건강 인식 및 걷기 실천과 무관하게 활동제한이 있는 집단의 민간의료보험 가입률이 낮았으며, 설명력은 51.7%이었다. 그러므로, 중증질환자 중 민간의료보험에 가입하지 못한 집단을 선별하여 생활환경 개선 및 지방자치단체의 지원을 촉구해야 할 것이다. 또한, 사회적 취약계층 및 건강행태에 제한 있는 집단을 대상으로 중증질환 예방을 위한 정부의 보건교육 또는 프로그램 제공 등 다양한 보건정책을 고려해야 할 것이다.

Keywords

References

  1. KOSIS, from:http://kosis.kr/index/index.jsp, 2017.09.15
  2. D. C. Hadorn, "The Oregon priority-setting exercise: quality of life and public policy", Hastings center report, vol. 21, no. 3, pp. S11-6, 1991. DOI: http://dx.doi.org/10.2307/3563329
  3. N. G. Seo, T. W. Kang, S. I. Hu, H. S. Shin, Y. H. Oh, S. H. Jung, D. S. Kim, J. H. Lee, N. J. Seong, S. M. Choi, "In-depth Analysis Report of Korean Medical Panel in 2015", National Health Insurance Corporation Health Insurance Policy Institute, 2015. DOI: https://doi.org/10.4235/agmr.2017.21.1.24
  4. H. M. Won, "2010 National Cancer Control Project Surveillance Survey", 2010.
  5. Y. G. Kim, "Cancer patients' need for financial assistance and its related factors[PhD thesis]", Gyeonggi: University of Ajou Graduate school of public health, 2010.
  6. J. H. Park, "The Effect of Householder's Characteristics and Perceptions of the Korean National Health Insurance Coverage on Getting Private Medical Insurances", Korea Social Policy Review, vol. 22, no. 1, pp. 217-241, 2015. https://doi.org/10.17000/kspr.22.1.201503.217
  7. C. Hamilton, "Healthy Provinces, Healthy Canadians, A provincial benchmarking report", Ottawa: The Conference Board of Canada, 2006.
  8. OECD. 2014 Health data, 2014.
  9. D. H. Kim, "Risk and Policy Improvement for the Four Major Severe Diseases", Proceedings of the Conference of Social Welfare Society for Criticism and Alternatives, 703-722, 2014.
  10. H. M. Shin, "Is supportive of rare intractable disease good? Policy Debate (Expansion of Four Major Severity Diseases: Support for Rare Incurable Diseases)", 2013.
  11. Y. H. Jeong, "Korea Health Care Commission, Ministry of Health and Welfare Issue & Focus", 70, 2011.
  12. S. B. Park, K. H. Jeong, "The Determinants of Private Health Insurance and Its Effects on Medical Utilization in Korea", Korean Insurance Academic Society, vol. 88, pp. 23-49, 2011.
  13. I. R. Baek, H. S. Park, S. S. Byun, "The Determinants and Medical Care Utilization Behavior of Private Health Insurance", The Korea Contents Society, vol. 12, no. 7, pp. 295-305, 2012. DOI: http://dx.doi.org/10.5392/JKCA.2012.12.07.295
  14. H. B. Lee, K. R. Hyun, "A Study for Characteristics and Factors of Private Health Insurers", The Korean Social Security Association, vol. 27, no. 1, pp. 217-240, 2011.
  15. S. J. Hyun, "Factors Associated with enrollment in new private health insurance and additional private health insurance", Health Service Management Review, vol. 9, no. 4, pp. 21-28, 2015. DOI: http://dx.doi.org/10.3961/jpmph.15.057
  16. C. H. You, S. W. Kang, J. H. Choi, E. H. Oh, Y. D. Kwon, "The Effect of Private Health Insurance on Health Care Utilization : Evidence from Korea Health Panel (2008-2010)", The Korean Journal of Health Service Management, vol. 8, no. 2, pp. 101-113, 2014. DOI: http://dx.doi.org/10.12811/kshsm.2014.8.2.101
  17. Y. C. Lee, B. H. Im, Y. H. Park, "The Determinants and Comparison of Health Behavior and Health Service by Private Medical Insurance on National Health-Nutrition Survey", The Korea Contents Society, vol. 10, no. 12, pp. 190-204, 2010. DOI: http://dx.doi.org/10.5392/JKCA.2010.10.12.190
  18. C. Sapelli, A. Torche, "The mandatory health insurance system in Chile: explaining the choice between public and private insurance", International Journal of Health Economics and Management, vol. 1, no. 2, pp. 97-110, 2001. DOI: https://doi.org/10.1023/A:1012886810415
  19. B. Lokuge, R. Denniss, T. A. Faunce, "Private health insurance and regional Australia", Medical journal of Australia, vol. 182, no. 6, pp. 290-293, 2005.
  20. D. King, E. Mossialos, "The determinants of private medical insurance prevalence in England, 1997-2000", Health services research, vol. 40, no. 1, pp. 195-212, 2005. DOI: http://dx.doi.org/10.1111/j.1475-6773.2005.00349.x
  21. T. C. Buchmueller, A. Couffinhal, M. Grignon, M. Perronnin, "Access to physician services: does supplemental insurance matter? evidence from France", Health Economics, vol. 13, no. 7, pp. 669-87, 2004. DOI: http://dx.doi.org/10.1002/hec.879
  22. B. Saliba, B. Ventelou, "Complementary health insurance in France Who pays? Why? Who will suffer from public disengagement?", Health Policy, vol. 81, no. 2, pp. 166-182, 2007. DOI: https://doi.org/10.1016/j.healthpol.2006.05.017
  23. T. C. Liu, C. S. Chen, "An analysis of private health insurance purchasing decisions with national health insurance in Taiwan", Social Science & Medicine, vol. 55, no. 5, pp. 755-774, 2002. DOI: https://doi.org/10.1016/S0277-9536(01)00201-5
  24. J. Y. Park, K. H. Kim, C. B. Kim, S. H. Shin, "Countermeasures of public insurance against the introduction of private health insurance", National Health Insurance Corporation, 2002.
  25. Y. S. Oh, "Reorganization of roles between national health insurance and private health insurance", Insurance Development Research, 2005.
  26. H. J. Kwon, "Effects of Economic Factors on Membership Transition in Private Health Insurance", Korean Association of Social Welfare Policy, vol. 38, no. 3, pp. 131-158, 2011. https://doi.org/10.15855/swp.2011.38.3.131
  27. C. H. You, S. W. Kang, Y. D. Kwon, E. H. Oh, "Influence Factors on Coverage Expansion of Private Health Insurance", The Korean Journal of Health Economics and Policy, vol. 16, no. 3, pp. 1-16, 2016.
  28. H. J. Kim, J. H. Lee, "Factors Associated with the Middle-aged or the Old-aged Koreans' Enrollment in Private Health Insurance", The Korea Contents Association, vol. 12, no. 12, pp. 683-693, 2012. DOI: https://doi.org/10.5392/JKCA.2012.12.12.683
  29. D. Doiron, G. Jones, E. Savage, "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance", Health economics, vol. 17, no. 3, pp. 317-334, 2008. DOI: http://dx.doi.org/10.1002/hec.1267
  30. A. Jerant, K. Fiscella, D. J. Tancredi, P. Franks, "Health insurance is associated with preventive care but not personal health behaviors", Journal of the American Board of Family Medicine, vol. 26, no. 6, pp. 759-767, 2013. DOI: http://dx.doi.org/10.3122/jabfm.2013.06.130054
  31. B. Berg, P. V. Dommelen, P. Stam, T. Laske-Aldershof, T. Buchmueller, F. T. Schut, "Preferences and choices for care and health insurance", Social Science & Medicine, vol. 66, no. 12, pp. 2448-2459, 2008. DOI: http://doi.org/10.1016/j.socscimed.2008.02.021
  32. C. T. Jurkovitz, S. Li, K. C. Norris, G. Saab, A. S. Bomback, A. T. Whaley-Connell, P. A. McCullough, "Association Between Lack of Health Insurance and Risk of Death and ESRD: Results From the Kidney Early Evaluation Program (KEEP)", Am J Kidney, vol. 61, no. 402, pp. S24-S32, 2013. DOI: http://dx.doi.org/10.1053/j.ajkd.2012.12.015
  33. H. S. Kim, Y. H. Park, "Related Factors on Health Service Utilization and Satisfaction of Health Center Clients - Using '2010 Community Health Survey'", The Korean Journal of Health Service Management, vol. 7, no. 3, pp. 95-109, 2013. DOI: http://dx.doi.org/10.12811/kshsm.2013.7.3.095
  34. E. L. Brooks, S. R. Preis, S. J. Hwang, J. M. Murabito, E. J. Benjamin, M. Kelly-Hayes, P. Sorlie, D. Levy, "Health Insurance and Cardiovascular Disease Risk Factors", Am J Med, vol. 123, no. 8, pp. 741-747, 2010. DOI: http://dx.doi.org/10.1016/j.amjmed.2010.02.013
  35. J. M. McWilliams, "Health Consequences of Uninsurance among Adults in the United States: Recent Evidence and Implications", The Milbank Quarterly, vol. 87, no. 2, pp. 443-494, 2009. DOI: http://dx.doi.org/10.1111/j.1468-0009.2009.00564.x
  36. Y. N. Park, "The Private Insurance Activation in the Global Medical Competitional Age and the Counterplot of the Medical Profession", Journal of the Korean Medical Association, vol. 51, no. 5, pp. 396-401, 2008. DOI: https://doi.org/10.5124/jkma.2008.51.5.396
  37. Ministry of Health and Welfare, "Health Insurance Mid-term protection plan reinforcement plan", http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=316755, 2015.