• 사회복지연구
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• 제45권3호
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• pp.151-178
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• 2014

대만의 분절된 사회보험 체계는 높은 계층화 효과를 보이는 보수주의 복지체제의 일반적 특성으로 간주된다. 그러나 대만의 사회보험은 서구의 보수주의 복지국가들과는 다른 차별성을 보인다. 첫 번째로 대만의 사회보험은 초기부터 다양한 급부를 제공하는 종합보험의 형식으로 발달하였다. 두 번째로 노동보험과 공무원보험의 계층화 효과가 서로 다르게 나타나는데, 노동보험은 노동자라는 보편적 지위에 기반한 탈계급적 보험 형식을 취한 반면, 공무원보험은 직종과 지위별로 분절된 체계로 발전하였다. 본 논문은 이러한 대만의 사회보험체계를 국가의 복지개입의 의도하지 않은 결과와 가입자들의 이해, 특히 공무원과 노동자 사이의 정치적, 경제적, 민족적으로 대립되는 정체성이 결합하여 만들어낸 결과임을 밝히고자 한다.

• Journal of Preventive Medicine and Public Health
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• 제24권3호
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• pp.441-458
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• 1991

공무원 및 사립학교교직원 의료보험과 직장의료보험에서 입원, 외래별 수진을, 건당진료비 (1985년 기준 불변가격), 건당진료일수 등의 장래예측을 통해 의료보험 진료비 안정화 방안을 마련하는데 기초자료로 제시하기 위하여, 이들의 $1979{\sim}89$년간 월별 통계자료를 이용, Box-Jenkins model인 ARIMA 모델을 적용하여 1994년 까지의 수진을, 건당진료비 및 건당진료일수를 예측한 결과를 요약하면 다음과 같다. 수진을, 건당진료비 및 건당진료일수의 ARIMA 모형을 제시하면 다음 표와 같다. 상기의 ARIMA 모형을 기초로하여 향후 5년간의 수진율을 예측한 결과, 공교의료보험 입원의 경우, 1989년의 실측치는 0.068건 이었으며, 1990년과 1991년은 0.068건, 1992년과 1993년은 0.069건, 1994년은 0.070건으로 연평균 0.7%정도 증가될 것으로 예측되었으며, 외래의 경우, 1989년의 실측치는 3.487건이었으나 1990년은 3.530건, 1994년은 3.668건으로 연평균 1%정도 증가될 것으로 예측되었다. 직장의료보험 입원의 경우, 1989년의 실측치는 0.063건이었으며, 1990년부터 1994년까지 모두 0.063건으로 안정될 것으로 예측되었으며, 외래의 경우 1989년의 실측치는 2.984건이었으나, 1990년은 3.016건, 1994년은 3.154건으로 연평균 1.1% 정도 증가될 것으로 예측되었다. 건당진료비의 향후 예측치는 12월을 기준으로하여 1985년 불변가격으로 공교의료보험 입원의 경우, 1989년의 실측치는 332,751원이었으나, 1990년은 345,938원, 1994년은 354,511원으로 연평균 0.6%정도 증가될 것으로 예측되었으며, 외래의 경우, 1989년의 실측치는 11,925원이었으나, 1990년은 12,638원, 1994년은 12,904원으로 연평균 0.5%정도 증가될 것으로 예측되었다. 직장의료보험 입원의 경우, 1989년 실측치는 281,835원이었으나, 1990년은 282,524원, 1994년은 293,973원으로 연평균 1%정도 증가될 것으로 예측되었으며, 외래의 경우, 1989년 실측치는 11,599원이었으나, 1990년부터 1994년까지 11,585원으로 안정될 것으로 예측되었다. 건당진료일수의 향후 예측치는 12월을 기준으로 하여 공교의료보험 입원의 경우, 1989년의 실측치는 13.79일이었으며, 1990년은 13.82일, 1993년과 1994년은 13.85일로 거의 안정될 것으로 예측되었으며, 외래의 경우, 1994년까지 5일 정도로 안정될 것으로 예측되었다. 직장의료보험 입원의 경우, 1989년의 실측치는 12.23일이었으나, 1990년은 12.30일, 1994년은 12.85일로 연평균 1.1%정도 증가될 것으로 예측되었으며, 외래의 경우 1989년의 실측치는 4.61일이었으며 1990년부터 1994년까지 4.60일로 안정될 것으로 예측되었다.

• 보건행정학회지
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• 제20권2호
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• pp.104-127
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• 2010

To vitalize the link program of Korean long-term care insurance system to community-based services for non-eligible people, we analysed the claim data from the Korean National Health Insurance Corporation (NHIC), and conducted a questionnaire survey to charging employees of elderly service department at local governments. The subjects were all 81,377 people, 57,454 of them were arranged to community-based services. The link program was more necessary among the missed subjects rather than the arranged people due to the need for physical or psychological assistance. By the result of the survey to the local government employees, 59.5% of subjects responded their proportion of link service was over 10% and under 20%, and 54.3% of them responded their job boundary are not clear. Major type of linking was notification the subject list to local government, 91.4%; proportion of periodical notification on the status of their service link were 57.1%, only 7.1% were followed to manage after the link. Difficult factors at the link process were pointed out the overload by other side work, deficiency of resources, rigidity of priority of link, and so on. Considering these results, to vitalize the community-based services to the non-eligible people, it may be essential the active participation of the subjects, construction of parts working in coordination among the institutions including NHIC, local governments, and service providers; development of various services for maintenance or promotion of the non-eligible peoples' health and functional status; and active participation of institutions from the third sector, and so on.

• 보건행정학회지
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• 제4권1호
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• pp.77-106
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• 1994

This study attempts to evaluate the beneficial equity and operational efficiency of the three Korean medical insurance programmes and thereby suggest directions for their policy improvement. Concepts of the equity and effciency were reviewed to develop indicators for comparative analysis. For the analysis, statistical and financial accounting data for 1991, issued by the National Federation of Medical Insurance and the Korea Medical Insurance Corporation, on the operational status and performances of the programmes, were collected and rearranged to be suited to the purpose of the study. The analysis reveals that beneficial inequity exists between self-employed and employee programs. and that operational inefficiency is prominent in both programms for self-employeds and for Government employees and private school teachers. In order to improve the beneficial inequity of the self-employed program, it is suggested that policies be formulated and implimented toward increasing the program revenue through increasing subsidies from the Government, and through inter- program finance adiustment. For the operational inefficiency of the two programs, it is judged that, toghether with the administrative support and control from the Government and the insurance society bodies, self- efforts be initiated to improve the internal mangement styles and systems of the insurance societies. Finally, from the viewpoint of the structural efficiency, expansion of the preventive insurance benefits by the insurance soceties is recommended both for beneficial equity and operational efficiency.

• 보건행정학회지
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• 제11권2호
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• pp.85-122
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• 2001

This study compared and analyzed the effect of income-redistribution, collecting data on the basis of the estimated details of insurance contribution and individual money wage lists for each one year before and after the combination of medical insurance program for industrial workers, by systematic sampling, extracting 4,160 families(14,764 people) among people applied to medical insurance program for self employees in Taegu City on the basis of Oct. 1st in 1998 with 227 associations of medical insurance program for self employees and medical insurance program for government employees and private school teachers combined, comparing the effect of income redistribution of before and after the combination of medical insurance program for self employees. The insurance contribution by household after the combination of medical insurance program for self employees showed the increase rate of average 20.9%, among them households of 68.8% increased and 31.2% decreased. The effect of income-redistribution was more positive because the degree of inequality was more deepened from 0.64 of the before-combination to 0.45 of the after-one in decile distribution ratio, from 0.26 to 0.34 in Gini -coefficient. Decile distribution ratio on the basis of insurance benefits by household was from 0.09 in the before-combination to 0.14 in the after-one, Gini-coefficient from 0.16 in the before-combination to 0.57 in the after-one was a little lowered. And decile distribution ratio of insurance benefits on the basis of insurance contribution was higher from 1.08 in the before-combination to 1.23 in the after-one, concentration index was a little lowered from 0.14 to 0.11, the effect of income-redistribution was improved in the phase of insurance benefits. The income-transfer rate of medical insurance program for self employees (the occupied rate of insurance benefits/ the occupied rate of insurance contribution) showed a lower trend in all of the before and after-combination towards upper classes, it was known that the income-transfer rate was higher from 1st degree to 7th degree in the after-combination in comparison with the before-one, but the effect of income¬redistribution was high because the income-transfer rate was lowered from 8th degree to 10th degree. The rate of medical insurance benefits (insurance benefits/ insurance contribution) increased from 0.79 in the before-combination to 1.07 in the after-one, and showed over 1.0 under 3th degree before the combination, but all of it was higher than 1.0 under 7th degree after the combination, the after-combination was more improved than the before-one in view of the rate of insurance benefits. As the result of above, on the basis of Oct. 1st in 1998 that 227 associations of medical insurance program for self employees was combined into one, we could say that the equality of imposing medical insurance contribution was more re-considered in the after-combination than in the before-one. But this study analyzed with classes divided, anyway, on the basis of insurance contribution, we have limit in explaining the correct effect of income-redistribution, because it was not analyzed according to classes of income, though it helps to analogize the effect of income-redistribution. So there must be analysis about the effect of income-redistribution, on the basis of the system, building up the system to grasp the correct income of the insureds of medical insurance program for self employees.

• 보건행정학회지
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• 제10권1호
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• pp.57-94
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• 2000

Korea's social health insurance system was introduced in 1977, which has made a universal coverage possibly by July 1989. Korean government had pursued a single objective for the last decade to put the whole population under the coverage of medical security, and the objective was achieved within 12 years. The rapid accomplishment is primarily due to such factors as limited benefits, high copayment rate, low contributions as well as rapid economic growth. There are several sources of pressure for the implementation of social health insurance such as health professional group, labor unions, politicians, international organizations etc.. However it is important to look at the feasibility of social health insurance. Among other things, it is necessary to identify the administrative infrastructure of insurance system and to assess income for source of fund. As many developed countries, Korea began to apply health insurance to the employees of the large firms, and the expansion based on employment status. Thus the several funds system was inevitable according to the gradual expansion strategy. However many persons had criticized several funds system in respect with equity and efficiency aspects. In the short history of the Korean health insurance, whether one fund or sever or funds had been the most controversial issue. In Febrary 1999, the National Assembly passed the act of one fund system. From July 2000 separate funds will be unifed under new health insurance scheme. In this study we will analyze the policy making process on implementation, expansion and integration of health insurance system of Korea. And also analyse problems related to policy making.

• 한국사회복지학
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• 제37권
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• pp.307-326
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• 1999

본 연구에서는 지난 1995년 실시된 도시지역의료보험조합과 농어촌지역의료보험의 통합 이후 나타난 조합재정 및 피보험자들의 의료서비스 이용강도에 있어서의 변화를 분석함으로써 지난 1998년 10월 실시된 지역의료보험과 공무원 교직원의료보험의 통합과, 더 나아가서는 오는 2000년 시행 예정에 있는 전체 의료보험통합으로 인해 나타날 수 있는 변화를 예측하는데 필요한 기초자료를 제공하고자 시도했다. 분석결과, 1995년 실시된 통합이 조합의 총지출 증가율 및 보험급여비 증가율에 변화를 가져왔다고 볼만한 결과는 발견할 수는 없었다. 또한 입원 및 외래진료 수진률과 건당진료비로 정의되는 의료서비스 이용강도에 있어서도 통합에서 비롯된 것이라 볼 수 있을 만한 뚜렷한 변화는 나타나지 않았다. 반면, 1995년의 통합이 조합의 평균관리운영비 증가율을 감소시키는 결과를 가져왔음을 발견할 수 있었다. 이러한 연구 결과가 갖는 정책적 함의에 대한 논의와 함께 앞으로의 의료보험통합을 위한 몇 가지 제언을 시도하였다.

• 농촌의학ㆍ지역보건
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• 제23권2호
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• pp.269-274
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• 1998

The purpose of this study is to establish the basic consultation data for diabetes in adults and to demonstate the necessity of preventive regular medical examinations. The study was carried out at Chungyang County, Chungchungnam-Do from the first of January, 1996 to the end of December. Below is the statistical data of this study which concerns the distinction of sex, ages, and occupations from the 600 examinees. 1. According to the distinction of sex, there are 12 males and 11 females among the 300 examinees in each group. That means, the diabetic percentage is 4.0% versus 3.6% and male/female diabetic ratio is 1.1:1 2. According to the distinction of ages, there is one people 0.25% aged 20years old and 5 peoples 1.3% aged 30 years old among the 400 examinees. There are 6 peoples 1.0% aged 40 years old and 6 peoples 1.0% aged 50 years old among the 600 examinees. There are 4 peoples 2.0% aged 60 years old among the 200 examinees. 3. According to the distinction of occupations, there are 13 white collar workers 6.5% among the 200 examinees, and there are 8 blue collar workers(4%) among the 200 examinees. There are 2 government employees 1% among the 200 examinees. This show that there is less diabets in government employees than other occupational groups of the same number. 4. Among the white and blue collar workers, 7 diabetis's blood glucose levels are 140mg%--200 mg% and 6 are 200mg%. 5. Among the community medical insurance holders, 7 diabetic's blood glucose levels are 140 mg%--200mg% and 1 is 200mg%. 6. Among the government employees, 2 diabetic's bleed glucose levels are 140mg--200mg% and there is no 200mg%.

• 보건의료산업학회지
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• 제5권3호
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• pp.13-23
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• 2011

This paper investigated the operating environment for the representative of each agency and the facility workers on the basis of analytical result of recognition changes of the operating environment changes under the operating the long-term care insurance. It was described plans to take positive effect on the operating as follows. The first, on the result of regression analysis, the service administrative range takes the biggest effect on the general recognition of executing the long-term care insurance off and on. The affirmative recognition of the service administrative range had the general recognition on the system be positive effect. But the operator of facility asserts that the care manager's professionalism related quality of service be strengthened. The second, on the result of regression analysis, in the financial accounting administrative it is revealed the more positive recognition it is, the more positive effects it has. From the difference verification of an operation size from operation subject, the small operation size and personal facility recognize the long term care insurance positively. On the other side the facilities where the operation size is big recognize the system negatively. The long-term care facility should rearrange a support program newly and the government needs to promote the donation activity, because it is needed to reduce the financial burden of facilities.

• 보건의료산업학회지
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• 제6권3호
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• pp.53-66
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• 2012

The main purpose of this research is to gain full understanding of how well people are aware and prepared for after retirement. To reach the goal to learn more about the upcoming aging society, professionals from variety of medical fields were employed as subjects to this research. In order to get a detailed result, and to provide an ideal suggestion, the research was conducted with 406 professional workers from 31 different medical institutions as its subjects. Obtained results were summarized as follows. First, in terms of government policies in the field, the idea of long term recuperation insurance gained more support than the belief that the public annuity is a sufficient economic countermeasure. Second, there is a causal relation between the economical preparation for retirement and the reason why people do not prepare for their after retirement. The more one feel short of money, the more one is obtuse towards the necessity of preparing for retirement, the more ignorant one is about preparing for retirement, the higher the chance that there will be no preparation done for his/her after retirement.