• 제목/요약/키워드: Social Security Expenditure

검색결과 35건 처리시간 0.022초

만성질환자에서 실손형 민간의료보험의 가입 관련 요인과 외래 의료이용의 관련 요인 (Factors Affecting the Purchase of Indemnity Private Health Insurance and Related Factors of Outpatient Healthcare Utilization among Chronic Disease Patients)

  • 허정원;권영대
    • 한국병원경영학회지
    • /
    • 제24권3호
    • /
    • pp.1-10
    • /
    • 2019
  • Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

Who has experienced better or worse health conditions since the outbreak of COVID-19?: results from a representative cross-sectional survey in Seoul

  • Eunbin Jo;Hyelim Yoo;Kirang Kim;Sunup Kim;Chul-Kyoo Kim;Haeyoen Lee;Jinsook Jeong;Sohyun Park
    • Nutrition Research and Practice
    • /
    • 제17권1호
    • /
    • pp.103-121
    • /
    • 2023
  • BACKGROUND/OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population in many ways. This study aimed to analyze the patterns of changes in eating, food purchasing and preparation, physical activity, and subjective health after COVID-19 outbreak by various sociodemographic factors and to understand the factors associated with changes in subjective health. SUBJECTS/METHODS: A cross-sectional survey using a representative sample from Seoul was used for the analysis. The data collection was conducted from September to October 2020. A total of 3,833 citizens aged more than 18 years old participated in the Seoul Food Survey. Descriptive statistics and generalized ordinal logistic regression models were used to understand the changes in health behaviors, health indicators, and subjective general health by various socioeconomic status. RESULTS: It was shown that the changes in household income, food expenditure, food consumption and physical activities differed significantly by age, education, occupation, income, weight, and food security status. Low-income and food-insecure households were affected more severely by the pandemic. Older age, household food insecurity, income reduction, increased home cooking and frequency of having instant foods, decreased physical activity and weight gain were significant factors explaining worse perceived health during the COVID-19 pandemic. CONCLUSIONS: The results suggest that focusing on older populations and low-income families with food insecurity should be prioritized during infectious disease outbreaks. In addition, the role of physical activities and instant food consumption in explaining perceived health should be investigated further in this prolonged battle with the pandemic situation.

기초연금제도 축소의 '트로이 목마' : 부유층 노인 수급제한조치에 대한 실증적 비판 (The 'Trojan Horse' of Old Age Income Security System Retrenchment in Korea : the Examination of Policy Changes on Basic Old Age Pension for the Rich)

  • 김성욱;한신실
    • 한국사회복지학
    • /
    • 제66권3호
    • /
    • pp.231-251
    • /
    • 2014
  • 정부는 부유층 기초연금 수급과 관련한 부정적 여론에 대응하기 위해 2014년 7월부터 6억 이상 자녀명의 주택 거주노인에 대해 소득인정액 산정 시 무료임차추정소득을 부과하고 증여재산 산정기간을 연장하는 등의 방안을 실시하고 있다. 본 연구는 이러한 개혁안의 효과성과 적정성을 평가하기 위해 '한국복지패널(7차자료)'을 활용한 가구별 소득인정액을 산출하여 부유층 노인의 수급실태와 재정소요규모를 추정하고, 정부안의 모의분석을 통해 수급자격 변동 등 정책효과를 살펴보았다. 분석결과, 첫째 기존 연구경향을 반영하여 부유층의 기준을 소득상위 10%로 설정할 경우 부유층 노인수급가구의 규모는 전체 수급가구의 2.9%이며, 이로 인한 재정지출규모는 총 급여지출액의 2.6%에 불과한 것으로 나타났다. 둘째, 가처분 소득, 부채, 사적이전을 고려할 때 정부안이 적용되는 가구의 경제수준은 정부안이 적용되지 않는 유사 경제수준의 가구보다 월등하게 높다고 보기 어려우며, 실제 정부안이 시행된다 하더라도 수급권 조정이 발생되는 가구는 극소수(약 0.7%)에 불과하였다. 셋째, 정부의 대책은 노인부양 가구를 차별할 뿐 아니라, 전체 노인가구를 대상으로 선정기준액을 새롭게 설정하지 않는 한 단순 급여삭감 조치에 불과하여 기초연금제도는 전반적으로 후퇴할 것으로 판단된다. 이러한 분석결과를 토대로 본 연구는 정부의 개혁방안이 과학적 예측과 진지한 토론이 부재한 상태에서 일부 부유층 노인의 급여수급에 대한 부정적 여론에 편승하여 개인 노후소득보장제도인 기초연금에 사실상의 부양의무자 기준을 적용함으로써 제도를 잔여화하고 향후 복지삭감에 유리한 정책환경을 조성하는 프로그램적-체계적 복지축소전략이라는 점을 강조하였다. 더욱 우려할만한 점은 이러한 정부안이 우리나라 노후소득보장제도의 기반을 흔들 수 있는 적대적인 사안임에도 불구하고, 최근 기초연금 논의에서 거의 주목받지 못하고 있다는 것이다.

  • PDF

교육수준과 비근로소득이 고령자 취업에 미치는 영향: 내생성을 고려한 패널로짓 모형 추정 (The Impacts of Education and Non-Labor Income on Employment Among the Elderly: An Estimation with a Panel Logit Model to Address the Problem of Endogenous Predictors)

  • 김철주
    • 한국사회정책
    • /
    • 제23권1호
    • /
    • pp.95-123
    • /
    • 2016
  • 고령화가 급속도로 진행됨에 따라 고령자의 취업 행동에 대한 객관적 분석은 효과적인 고령자 고용정책의 설계와 안정적인 노후소득보장 체제 개편을 위해 반드시 필요한 선결과제가 되었다. 고령자의 취업 결정요인을 분석하고자 한 선행연구들은 교육수준이나 비근로소득이 취업확률에 미치는 영향을 추정함에 있어 고령자 개인의 비관측 이질성과 독립변수 내생성 문제를 고려하지 못했으며, 따라서 그렇게 추정된 이들 두 변수의 회귀계수는 일치추정량으로 간주될 수 없다. 이 연구는 한국고용정보원의 고령화연구패널조사 1~4차웨이브 자료를 이용하여 패널로짓 모형을 추정함으로써 교육수준과 비근로소득의 효과에 대한 일치 추정량을 구하고자 했다. 그 결과, 비관측 이질성이나 내생성 문제를 고려한 후에도 교육수준과 비근로소득은 고령자 취업에 유의미한 음의 영향을 미친다는 것이 재확인되었다. 이러한 연구 결과는 향후 과거 어느 세대보다 학력이 높고 연금 등 비근로 소득이 높은 세대집단인 베이비부머들이 노동시장을 떠날 시점이 되면, 다른 조건이 동일할 경우 이들의 취업 유인은 그 이전세대의 그것보다 훨씬 더 약할 것이며 따라서 전례 없는 노동시장 인력부족과 연금재정 고갈이 초래될 수 있음을 시사한다. 마지막으로 이에 대비하기 위한 정책 방향으로 저학력 저소득 고령자와 고학력 고소득 고령자 각각을 대상으로 하는 취업지원 정책의 개편 방안을 제안한다.

한국전쟁의 교훈과 대비 -병력수(兵力數) 및 부대수(部隊數)를 중심으로- (The lesson From Korean War)

  • 윤일영
    • 안보군사학연구
    • /
    • 통권8호
    • /
    • pp.49-168
    • /
    • 2010
  • Just before the Korean War, the total number of the North Korean troops was 198,380, while that of the ROK(Republic of Korea) army troops 105,752. That is, the total number of the ROK army troops at that time was 53.3% of the total number of the North Korean army. As of December 2008, the total number of the North Korean troops is estimated to be 1,190,000, while that of the ROK troops is 655,000, so the ROK army maintains 55.04% of the total number of the North Korean troops. If the ROK army continues to reduce its troops according to [Military Reform Plan 2020], the total number of its troops will be 517,000 m 2020. If North Korea maintains the current status(l,190,000 troops), the number of the ROK troops will be 43.4% of the North Korean army. In terms of units, just before the Korean War, the number of the ROK army divisions and regiments was 80% and 44.8% of North Korean army. As of December 2008, North Korea maintains 86 divisions and 69 regiments. Compared to the North Korean army, the ROK army maintains 46 Divisions (53.4% of North Korean army) and 15 regiments (21.3% of North Korean army). If the ROK army continue to reduce the military units according to [Military Reform Plan 2020], the number of ROK army divisions will be 28(13 Active Division, 4 Mobilization Divisions and 11 Local Reserve Divisions), while that of the North Korean army will be 86 in 2020. In that case, the number of divisions of the ROK army will be 32.5% of North Korean army. During the Korean war, North Korea suddenly invaded the Republic of Korea and occupied its capital 3 days after the war began. At that time, the ROK army maintained 80% of army divisions, compared to the North Korean army. The lesson to be learned from this is that, if the ROK army is forced to disperse its divisions because of the simultaneous invasion of North Korea and attack of guerrillas in home front areas, the Republic of Korea can be in a serious military danger, even though it maintains 80% of military divisions of North Korea. If the ROK army promotes the plans in [Military Reform Plan 2020], the number of military units of the ROK army will be 32.5% of that of the North Korean army. This ratio is 2.4 times lower than that of the time when the Korean war began, and in this case, 90% of total military power should be placed in the DMZ area. If 90% of military power is placed in the DMZ area, few troops will be left for the defense of home front. In addition, if the ROK army continues to reduce the troops, it can allow North Korea to have asymmetrical superiority in military force and it will eventually exert negative influence on the stability and peace of the Korean peninsular. On the other hand, it should be reminded that, during the Korean War, the Republic of Korea was attacked by North Korea, though it kept 53.3% of troops, compared to North Korea. It should also be reminded that, as of 2008, the ROK army is defending its territory with the troops 55.04% of North Korea. Moreover, the national defense is assisted by 25,120 troops of the US Forces in Korea. In case the total number of the ROK troops falls below 43.4% of the North Korean army, it may cause social unrest about the national security and may lead North Korea's misjudgement. Besides, according to Lanchester strategy, the party with weaker military power (60% compared to the party with stronger military power) has the 4.1% of winning possibility. Therefore, if we consider the fact that the total number of the ROK army troops is 55.04% of that of the North Korean army, the winning possibility of the ROK army is not higher than 4.1%. If the total number of ROK troops is reduced to 43.4% of that of North Korea, the winning possibility will be lower and the military operations will be in critically difficult situation. [Military Reform Plan 2020] rums at the reduction of troops and units of the ground forces under the policy of 'select few'. However, the problem is that the financial support to achieve this goal is not secured. Therefore, the promotion of [Military Reform Plan 2020] may cause the weakening of military defence power in 2020. Some advanced countries such as Japan, UK, Germany, and France have promoted the policy of 'select few'. However, what is to be noted is that the national security situation of those countries is much different from that of Korea. With the collapse of the Soviet Unions and European communist countries, the military threat of those European advanced countries has almost disappeared. In addition, the threats those advanced countries are facing are not wars in national level, but terrorism in international level. To cope with the threats like terrorism, large scaled army trops would not be necessary. So those advanced European countries can promote the policy of 'select few'. In line with this, those European countries put their focuses on the development of military sections that deal with non-military operations and protection from unspecified enemies. That is, those countries are promoting the policy of 'select few', because they found that the policy is suitable for their national security environment. Moreover, since they are pursuing common interest under the European Union(EU) and they can form an allied force under NATO, it is natural that they are pursing the 'select few' policy. At present, NATO maintains the larger number of troops(2,446,000) than Russia(l,027,000) to prepare for the potential threat of Russia. The situation of japan is also much different from that of Korea. As a country composed of islands, its prime military focus is put on the maritime defense. Accordingly, the development of ground force is given secondary focus. The japanese government promotes the policy to develop technology-concentrated small size navy and air-forces, instead of maintaining large-scaled ground force. In addition, because of the 'Peace Constitution' that was enacted just after the end of World War II, japan cannot maintain troops more than 240,000. With the limited number of troops (240,000), japan has no choice but to promote the policy of 'select few'. However, the situation of Korea is much different from the situations of those countries. The Republic of Korea is facing the threat of the North Korean Army that aims at keeping a large-scale military force. In addition, the countries surrounding Korea are also super powers containing strong military forces. Therefore, to cope with the actual threat of present and unspecified threat of future, the importance of maintaining a carefully calculated large-scale military force cannot be denied. Furthermore, when considering the fact that Korea is in a peninsular, the Republic of Korea must take it into consideration the tradition of continental countries' to maintain large-scale military powers. Since the Korean War, the ROK army has developed the technology-force combined military system, maintaining proper number of troops and units and pursuing 'select few' policy at the same time. This has been promoted with the consideration of military situation in the Koran peninsular and the cooperation of ROK-US combined forces. This kind of unique military system that cannot be found in other countries can be said to be an insightful one for the preparation for the actual threat of North Korea and the conflicts between continental countries and maritime countries. In addition, this kind of technology-force combined military system has enabled us to keep peace in Korea. Therefore, it would be desirable to maintain this technology-force combined military system until the reunification of the Korean peninsular. Furthermore, it is to be pointed out that blindly following the 'select few' policy of advanced countries is not a good option, because it is ignoring the military strategic situation of the Korean peninsular. If the Republic of Korea pursues the reduction of troops and units radically without consideration of the threat of North Korea and surrounding countries, it could be a significant strategic mistake. In addition, the ROK army should keep an eye on the fact the European advanced countries and Japan that are not facing direct military threats are spending more defense expenditures than Korea. If the ROK army reduces military power without proper alternatives, it would exert a negative effect on the stable economic development of Korea and peaceful reunification of the Korean peninsular. Therefore, the desirable option would be to focus on the development of quality of forces, maintaining proper size and number of troops and units under the technology-force combined military system. The tableau above shows that the advanced countries like the UK, Germany, Italy, and Austria spend more defense expenditure per person than the Republic of Korea, although they do not face actual military threats, and that they keep achieving better economic progress than the countries that spend less defense expenditure. Therefore, it would be necessary to adopt the merits of the defense systems of those advanced countries. As we have examined, it would be desirable to maintain the current size and number of troops and units, to promote 'select few' policy with increased defense expenditure, and to strengthen the technology-force combined military system. On the basis of firm national security, the Republic of Korea can develop efficient policies for reunification and prosperity, and jump into the status of advanced countries. Therefore, the plans to reduce troops and units in [Military Reform Plan 2020] should be reexamined. If it is difficult for the ROK army to maintain its size of 655,000 troops because of low birth rate, the plans to establish the prompt mobilization force or to adopt drafting system should be considered for the maintenance of proper number of troops and units. From now on, the Republic of Korean government should develop plans to keep peace as well as to prepare unexpected changes in the Korean peninsular. For the achievement of these missions, some options can be considered. The first one is to maintain the same size of military troops and units as North Korea. The second one is to maintain the same level of military power as North Korea in terms of military force index. The third one is to maintain the same level of military power as North Korea, with the combination of the prompt mobilization force and the troops in active service under the system of technology-force combined military system. At present, it would be not possible for the ROK army to maintain such a large-size military force as North Korea (1,190,000 troops and 86 units). So it would be rational to maintain almost the same level of military force as North Korea with the combination of the troops on the active list and the prompt mobilization forces. In other words, with the combination of the troops in active service (60%) and the prompt mobilization force (40%), the ROK army should develop the strategies to harmonize technology and forces. The Korean government should also be prepared for the strategic flexibility of USFK, the possibility of American policy change about the location of foreign army, radical unexpected changes in North Korea, the emergence of potential threat, surrounding countries' demand for Korean force for the maintenance of regional stability, and demand for international cooperation against terrorism. For this, it is necessary to develop new approaches toward the proper number and size of troops and units. For instance, to prepare for radical unexpected political or military changes in North Korea, the Republic of Korea should have plans to protect a large number of refugees, to control arms and people, to maintain social security, and to keep orders in North Korea. From the experiences of other countries, it is estimated that 115,000 to 230,000 troops, plus ten thousands of police are required to stabilize the North Korean society, in the case radical unexpected military or political change happens in North Korea. In addition, if the Republic of Korea should perform the release of hostages, control of mass destruction weapons, and suppress the internal wars in North Korea, it should send 460,000 troops to North Korea. Moreover, if the Republic of Korea wants to stop the attack of North Korea and flow of refugees in DMZ area, at least 600,000 troops would be required. In sum, even if the ROK army maintains 600,000 troops, it may need additional 460,000 troops to prepare for unexpected radical changes in North Korea. For this, it is necessary to establish the prompt mobilization force whose size and number are almost the same as the troops in active service. In case the ROK army keeps 650,000 troops, the proper number of the prompt mobilization force would be 460,000 to 500,000.

  • PDF