• Health Policy and Management
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• v.34 no.2
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• pp.196-210
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• 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.

• 한국사회정책
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• v.25 no.4
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• pp.265-299
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• 2018

The pilot project for type diversification of self-sufficient support center that convert the centre corporation into social cooperative was introduced in 2015. That aimed to increase the number of participants of self-sufficient programmes and to create more jobs for the working poor through expanding the center's autonomy of usage of budget and arrangement of self-sufficient programmes. This study analyzed the organization transmitting processes and changes of the centers took part in the pilot project, then aimed to suggest the improvement schemes to be helpful for reinforcing positive efforts and removing obstacles in the process converting. The results show that converting into social cooperative is a choice for the sustainability of the centers led by surroundings rather than self-initiated plan. There are some positive changes that are increasing the enterprising spirit and obligation of the center staff. Further more, the cooperation with other community organizations is enhanced based on achieving regional recognition, and support of local governments and the opportunity for new businesses are expanded. However, these are very limited in the regions where social economy is undeveloped. Eventually, we should seek the development schemes of the pilot project considering the reduction of the number of participants in self-sufficient programmes and decreasing of their ability to work, even if some positive aspects are revealed.