보건의료산업학회지 (The Korean Journal of Health Service Management)

  • 제14권1호
  • /
  • Pages.147-159
  • /
  • 2020
  • /
  • 2093-5986(pISSN)
  • /
  • 2288-0666(eISSN)
보건의료산업학회 (Korea Society of Health Service Management)
권호 표지
DOI QR코드

DOI QR Code

65세 이상 본인부담 상한 적용 노인의 의료서비스 이용 현황과 특성

Status and Characteristics of Applying a Copayment Ceiling for the Elderly

  • 박초열 (부산가톨릭대학교 일반대학원 병원경영학전공) ;
  • 박영희 (부산가톨릭대학교 병원경영학과)
  • 투고 : 2020.02.01
  • 심사 : 2020.03.30
  • 발행 : 2020.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: This study is the human factors and disease factors of the copayment system for the elderly (>65 years old) and to identify does the current status and characteristics of the applied elderly and conducted to provide basic data. Methods: Sample cohort data from the National Health Insurance Corporation database, from the years 2012-2015, were analyzed of 21,772 elderly people over the copayment ceiling. Results: The ratio of those who exceeded the copayment ceiling system rose sharply from progressive rates of 3.39% in 2012, 3.69% in 2013 and 5.03% in 2014, to rates of 37.13% from 2013. Factors identified that affect the instances of being over the copayment ceiling were: age, income group, region, severity, disability, sickness distribution, inpatient days, and outpatient days. Conclusions: The reorganization of the copayment ceiling system in 2014 favored low-income families of the elderly, but in 2015, the proportion of elderly was low (only 5.78%). The government's policies needs to change to allow for the amount of the deductible upper limit for low- and middle- income groups to be further subdivided in order for the elderly to receive more deductibles.

키워드

참고문헌

  1. http://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=TX_35001_A030&vw_cd=MT_ZTITLE&list_id=350_35001_C&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=K1&path
  2. K.A. Kim(2011), A Study on Patient Attributes for Catastrophic User-Paid Expenditure in National Health Insurance, Department of Healthcare Management The Graduate School of Kyung Hee University, pp.1-66.
  3. Y.S. Choe, S.H. Tae, D.K. Son, G.Y. Kim(2011), Efficiency Plan of copayment system, National health insurance, Health Insurance Policy Researcher, pp.23-27.
  4. https://www.kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=361108
  5. http://kostat.go.kr/portal/korea/kor_nw/1/2/1/index.board?bmode=read&bSeq=&aSeq=373873&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt
  6. Y.S. Park, W.K. Yoo, S.S. Han, M.J. Kong(2019), Association Between Health Status and Physical Activity among Korean Older Adults, The Korean Journal of Health Service Management, Vol.13(3);93-103.
  7. Y.H. Jung, L.N. Byon, S.J. Ko(2011), Lifetime Distribution of Medical Cost in Korea, Health and Social Welfare Review, Vol.31(1);194-216. https://doi.org/10.15709/hswr.2011.31.1.194
  8. http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1BPA002&vw_cd=MT_TM1_TITLE&list_id=101_A0502&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=MT_TM1_TITLE&path=%252FeasyViewStatis%252FcustomStatisIndex.do
  9. H.R. Yoo(2016), A Study on the Effectiveness of Out-of-Poket Maximum on the Health Care Utilizations: Focused on the Insured of National Health Insurance System, The Graduate School Yonsei University, pp.1-96.
  10. Y.S. Hwang(2018), A Study on the Change of Medical Use pattern before and after the Improvement of Copayment Ceiling system, The Graduate School Yonsei University, pp.1-64.
  11. S.J. Im, S.H. Kim, E.H. Choe(2015), Analysis of the impact of the system for improving the out-of-pocket ceiling and a study of policy plans, National health insurance, Health Insurance Policy Researcher, pp.17-46.
  12. J.E. Ko(2019), Comparison of equity in healthcare utilization and expenditures among older people by region, School Public Health Seoul National University, pp.1-47.
  13. H.O. Lee(2017), Effect of four major severe diseases benefit expansion policy: Focused on health care utilization and catastrophic health expenditure, The Graduate School Chung-Ang University, pp.1-49.
  14. S.J. Im, H.N. Shin, D.K, Son(2018), A Study on Rationalization of Copayment Limitation by Reforming Health Insurance System and Expanding Coverage, National health insurance, Health Insurance Policy Researcher, pp.13-97.
  15. H.R. Yoo, J.S. Kim(2016), A Study on Effectiveness of Out-of-Pocket Maximum in the National Health Insurance, Social Security Research, Vol.21(2);135-164.

피인용 문헌

  1. Long-term exposure to fine particulate matter and incident asthma among elderly adults vol.272, 2021, https://doi.org/10.1016/j.chemosphere.2021.129619