• Title/Summary/Keyword: 본인부담 완화

Search Result 8, Processing Time 0.022 seconds

The Effects of the Revised Elderly Fixed Outpatient Copayment on the Health Utilization of the Elderly (노인외래정액제 개선이 고령층의 의료이용에 미친 영향)

  • Li-hyun Kim;Gyeong-Min Lee;Woo-Ri Lee;Ki-Bong Yoo
    • Health Policy and Management
    • /
    • v.34 no.2
    • /
    • pp.196-210
    • /
    • 2024
  • Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

The Effect of Private Health Insurance on the Subjective Burden of Medical Expenses (민간의료보험 가입 여부가 본인부담 진료비의 주관적 부담 수준에 미치는 영향)

  • Hong, Jin Hyuk;Noh, Jin-Won;Park, Kisoo;Lee, Yejin;Kwon, Young Dae
    • The Journal of the Korea Contents Association
    • /
    • v.17 no.6
    • /
    • pp.63-70
    • /
    • 2017
  • Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

2009년 및 2015년 사학연금법 개정에 따른 기준소득 변경의 연금소득에 대한 효과 연구

  • Kim, Yong-Ha
    • Journal of Teachers' Pension
    • /
    • v.4
    • /
    • pp.91-123
    • /
    • 2019
  • 본 연구는 2009년 법 개정에 따른 기준소득의 변경이 가입자별 보험료 부담과 연금급여의 변경에 어떠한 영향을 주었는지를 구체적 사례를 중심으로 살펴봄으로써 제도 변경 전후의 가입자별의 연금소득 변화를 산정함과 아울러, 2015년 사학연금법 개정에 따른 사학연금 가입자간 소득재분배제도의 도입이 2009년 법 개정에 따른 연금소득효과에 어떠한 영향을 주었는지를 분석하였다. 분석 결과, 사학연금가입자의 경우 법 개정 당시의 전제가 되었던 기준소득대비 보수월액의 비율인 65% 수준에 근접하는 사람은 일부에 불과한 것으로 나타났다. 즉, 60~70%기준에 포함되는 계층은 5.6%에 불과하고, 60% 이하인 자가 88.6%, 70% 이상인 자는 5.8%로 나타났다. 이는 사학연금 가입자 상당수가 기존의 보수월액이 실제 과세소득의 일정비율보다 낮은 위상에 있었음을 의미한다. 따라서 2009년 법 개정 결과, 처음의 기대와는 달리 개정 이전 연금액에 비하여 높아지는 가입자가 87.5%, 낮아지는 가입자가 12.5%인 것으로 나타났다. 그렇지만 연금액이 증가되었지만 보험료 부담이 함께 증가되었기 때문에 수익비 측면에서 더 유리해졌다고 할 수 없다. 더 부담하고 더 많이 받는 경우가 대다수였다. 물론, 오히려 기준소득이 보수월액보다 절대치조차 낮은 가입자도 있었다. 이 경우, 본인의 희망에 따라 법령에서 별도로 정한 최저소득기준을 선택할 수 있도록 함으로써 문제점이 완화되었다. 2009년 법 개정 상에 나타난 연금액 증가는 소득재분배 요소를 도입한 2015년 법 개정으로 상대적으로 저소득 가입자는 연금액이 증가하고 고소득자는 연금액이 감소됨으로써, 2009년 법 개정에서 나타난 고소득자에게 유리할 수 있는 부분이 완화되는 결과를 만들었다. 2015년 개정은 2009년 개정 상 발생한 문제를 다소 보완하는 결과가 되었다. 공무원의 보수월액을 적용하여왔던 제도를 기준소득월액으로 바꾼 것은 사학연금 가입자가 실제의 소득에 기초하여 보험료를 부담하고 연금을 지급받을 수 있도록 되었다는 점에서 제도의 정상화로 보는 것이 바람직하다. 소득기준의 전환으로 내재적으로 혼란이 발생할 가능성이 있었지만, 2015년의 법 개정으로 제도가 보다 완결적으로 발전가능하게 된 것으로 평가된다.

Study on Management Plan of the Financial Supervisory Service According to Increase of Risk of Household Debts (금융권 가계부채 위험증가에 따른 금융감독원 관리방안에 관한 연구)

  • Lee, YunHong
    • Korean Journal of Construction Engineering and Management
    • /
    • v.19 no.2
    • /
    • pp.96-106
    • /
    • 2018
  • The government adopted activation policy of real estate to overcome low economic growth rate. Real estate activation plan adopted by the government raised credit limit by lowering the regulation, and reduced real estate investment cost by reducing the base rate. Also, delayed transfer tax on multi-house owner to activate real estate investment and resolved purchase right resale. Relief of real estate regulate caused increase of housing sales and price increase, and the real estate market changed to overheating aspect such as premium upon completion of lot sale in a short time. Such market atmosphere greatly increased household debs as owners own houses based on 'financial debt' instead of their income. Since 2017, real estate policy was reinforced to reduce household debts and lending rate was raised due to rise of base rate, accordingly, burden of household debt is expected to increase. This research suggested a plan for the Financial Supervisory Service to efficiently manage the financial world by analyzing the cause and problem of household debs.

Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
    • /
    • v.18 no.2
    • /
    • pp.128-135
    • /
    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

A Study on the Insurance Contribution and Health Care Utilization of the Regional Medical Insurance Scheme (1개 군지역 의료보험제도에서의 보험료 부담수준별 병.의원 의료이용에 관한 연구)

  • Lee, Sang-Il;Choi, Hyun-Rim;Ahn, Hyeong-Sik;Kim, Yong-Ik;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
    • /
    • v.22 no.4 s.28
    • /
    • pp.578-590
    • /
    • 1989
  • This study was conducted to assess the equity in the regional insurance scheme through analysis of the computerized data from one regional insurance society and National Federation of Medical Insurance. We analysed the insurance contribution and benefit by the classes based on total and income-related contribution per household. The major findings of this study are as follows : 1. The average proportion of income-related contribution among the total was 39.2% and the upper classes show higher proportion of the income-related contribution. 2. The upper classes show higher health care utilization rate than the lower classes. It suggests that the lower classes have relatively large unmet medical needs. 3. The analysis through the Lorenz curve reveals that there exists transference of contributions from the upper to lower classes. But the cumulative percentage of insurance benefit is smaller than that of the number of the insured. It implies that regional medical insurance scheme in Korea has still some inequity in the context of social security principles.

  • PDF

A Study on Problems and Improvement of Home-help Services of Long-term Care Insurance (노인장기요양보험 재가서비스의 문제점과 개선방안)

  • Lee, Jun Woo;Jin, Hee
    • 한국노년학
    • /
    • v.29 no.1
    • /
    • pp.149-175
    • /
    • 2009
  • The purpose of this research is to analyze the overall problems at the moment of October 2008, and then to find the improvements of home-help services of the Long-Term Care Insurance(LTCI), which has been revealed many problems since it was released in July 2008. The research uses the literature survey which analyzes 2nd-hand materials studied by other people already, and survey research was executed from active social workers in the area of LTCI. Based on the policy analysis framework of Gilbert and Specht, all the data are analyzed in the scopes of client·benefit(service)·finance·transferring system. This research has found the problems in each scope of home-help services of the LTCI. Firstly, the client system has some problems in mismatching between registered and service clients, estimating client number, and judging service levels. Secondly, the service system reveals deficiency in professionality of social workers, service quality lowering by loose qualification criteria on workers, non-reasonable limitation of service time available, and the same fare system applied to visiting-help service in spite of different levels. Thirdly, in financing system, clients need to pay additional money to get extra services such as meal, hair cutting, bathing etc., due to government financial support stopped, some organizations have to reduce services and replace full-time workers to part-time ones, which makes the service quality worse. Lastly, in the transferring system, the management system for service quality is not well prepared. There are too much competion because of allowing too many home-help service organizations and care worker academies. The suggestions that this research has found to improve the policy are as follows. ① It is desirable to make the registered clients the service ones as many as possible in the long term perspective. ② The LTCI organization requires more workers and higher professionality. ③ Many elderly people who are not eligible now require connection system to be more served. ④ Management system and service manual for care worker are to be developed. ⑤ Laws related to the service contents and process should be modified, the proportion of client charge needs to adjust. ⑥ Home-help service organization licensed by the LTCI needs to be financially supported publicly. ⑦ Monitoring system to home-help service organization needs to be strengthened. ⑧ Evaluation tools to home-help service organization and workers is required. ⑨ Specification to open the home-help service organization needs to be more strict.

Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
    • /
    • v.22 no.4 s.28
    • /
    • pp.555-577
    • /
    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

  • PDF