보건행정학회지 (Health Policy and Management)

  • 제20권1호
  • /
  • Pages.37-63
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  • 2010
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  • 1225-4266(pISSN)
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  • 2289-0149(eISSN)
한국보건행정학회 (Korean Academy of Health Policy and Management)
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노인장기요양보험 급여비용의 중장기 추계

Projecting Public Expenditures for Long-Term Care in Korea

  • 발행 : 2010.03.31
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초록

Public expenditures on long-term care are a matter of concern for Korea as in many other countries. The expenditure is expected to accelerate and to put pressure on public budgets, adding to that arising from insufficient retirement schemes and other forms of social spending. This study tried to foresee how much health care spending could increase in the future considering demographic and non-demographic factors as the drivers of expenditure. Previous projections of future long-term expenditure were mainly based on a given relation between spending and age structure. However, although demographic factors will surely put upward pressure on long-term care costs, other non-demographic factors, such as labor cost increase and availability of informal care, should be taken into account as well. Also, the possibility of dynamic link between health status and longevity gains needs to be considered. The model in this study is cell-base and consists of three main parts. The first part estimated the numbers of elderly people with different levels of health status by age group, gender, household type. The second part estimated the levels of long-term care services required, by attaching a probability of receiving long-term care services to each cell using from the sample from current year. The third part of the model estimated long-term care expenditure, along the demographic and non-demographic factors' change in various scenarios. Public spending on long-term care could rise from the current level of 0.2~0.3% of GDP to around 0.44~2.30% by 2040.

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참고문헌

  1. 고영선 제 1장 중기 재정운용 방향. 국가재정운용계획 총괄 및 총량분야 작업반 편. 2009-2013 국가재정운용계획 총괄 및 총량 분야 보고서. 서울 : 한국개발연구원 ; 2009. 쪽 5-58.
  2. 김진수, 서동민, 이동헌, 최인덕, 김경하. 노인수발보험제도 도입에 따른 재정소요 전망 및 재원 분담 방안. 서울: 국민건강보험공단 ; 2006.
  3. 박명화, 김은정, 김은주, 김정선, 김한곤, 김혜령 등. 2008년도 전국 노인생활실태 및 복지욕구 조사. 서울 : 계명대학교 ; 2009.
  4. 박종연. 장기요양보험 재정운영의 지속 가능성. 제43회 한국보건행정학회 후기학술대회 2009. 보건복지가족부. 노인장기요양보험 통계월보(2008년 7월-2009년 8월). 국민건강보험공단 내부자료 ; 2009.
  5. 보건복지부. 노인장기요양보험 재정추계 자료. 2007.9.5.
  6. 서동민, 장병원. 노인요양보장제도 도입에 따른 재정추계 기본모형 개발 및 관련변수에 대한 연구. 사회보장연구 2005 ; 21(4) ; 161-198.
  7. 서동민. 노인장기요양보험제도의 재정구조와 전망. 보건경제와 정책연구 2008;14(2):27-56.
  8. 선우덕, 김찬우, 최정수, 최혜지, 연병길, 원장원 등. 노인장기요양보험제도 시범사업 평가연구 (2차). 서울 : 한국보건사회연구원 ; 2007.
  9. 선우덕, 이수형, 손창균, 유근춘, 신호성, 최영 등. 노인장기요양보장체계의 현황과 개선방안. 서울 : 한국보건사회연구원 ; 2008.
  10. 윤희숙, 박능후, 정경희, 전병유, 권용진. 노인장기요양보험 시행 1년의 현황과 개선방안. 서울 : 한국개발연구원 ; 2009.
  11. 이가옥, 서미경, 고경환, 박종돈. 노인생활실태 분석 및 정책과제. 서울 : 한국보건사회연구원 ; 1994.
  12. 일본 노동후생성. 개호보험사업현황보고. Available from: URL: http://www.mhlw.go.jp. 2009.6.
  13. 정경희, 조애저, 오영희, 변재관, 변용찬, 문현상. 1998년도 전국 노인생활실태 및 복지욕구조사. 서울 : 한국보건사회연구원 ; 1998.
  14. 정경희, 석재은, 선우덕, 김찬우, 이태화, 이태진 등. 공적노인요양보장제도 평가. 판정체계 및 급여. 수가개발. 서울 : 한국보건사회연구원 ; 2005a.
  15. 정경희, 오영희, 석재은, 도세록, 김찬우, 이윤경 등. 2004년도 전국 노인생활실태 및 복지욕구 조사. 서울 : 한국보건사회연구원 ; 2005b.
  16. 정완교, 진양수. 장기요양서비스의 수요 분석, 서울 : 한국개발연구원 ; 2008.
  17. 정형선, 서동민. 제11장 노인수발보험 재정추계. 선우덕 등 편. 노인수발보험제도 시범사업 평가연구(1차). 서울 : 한국보건사회연구원 ; 2006. 쪽 453-526.
  18. 최병호, 선우덕, 최현미. 노인요양보험제도 도입방안 연구. 서울 : 한국보건사회연구원 ; 2001.
  19. 통계청. 장래인구추계(2006.12). Available from: URL : http://www.kosis.kr., 2006a
  20. 통계청. 사회조사보고서. Available from : URL: http://www.kosis.kr. 1999, 2003, 2006b, 2008.
  21. 통계청. 2008 고령자통계 보도자료. 2008.10.2.
  22. 한진희, 최경수, 신석하, 임경묵, 김종일. 고령화 사회의 장기 거시경제변수 전망 : 2006- 2080. 서울 : 한국개발연구원 ; 2007.
  23. Bauer E J. Transitions from Home to Nursing Home in a Capitated Long-Term Care Program: The Role of Individual Support Systems. Health Services Research 1996 ; 31(3); 309-326.
  24. Baumol W J, Bowen W G. Performing Arts : The Economic Dilemma, New York: The Twentieth Century Fund :1966.
  25. Comas-Herrera A, Costa-Font J, Gori C, di Maio A, Patxot C, Pickard L, et al. European Study of Long-Term Care Expenditure. London : PSSRU Discussion Paper 1840 London School of Economics ; 2003a.
  26. Comas-Herrera A, Pickard L, Wittenberg R, Davies B, Darton R. Future Demand for Long-Term Care, 2001 to 2031 : Projections of demand for older people in England. London : PSSRU Discussion Paper 1980 London School of Economics; 2003b.
  27. Fries J F. Aging, natural death, and the compression of morbidity. The New England Journal of Medicine 1980; 303(3) ; 130-135.
  28. Fuchs V R. Though much is taken: reflections on aging, health and medical care. The Milbank Memorial Fund Quarterly- Health and Society 1984 ; 62(2) ; 143-166.
  29. Garber A M, Macurdy T E. Predicting Nursing Home Utilization among the High-Risk Elderly. In : Wise D A editors. Issues in the Economics of Aging. Chicago: University of Chicago Press ; 1990. pp.173-200.
  30. Headen Jr. A E. Time Costs and Informal Social Support as Determinants of Differences between Black and White Families in the Provision of Long-Term Care. Inquiry 1992 ; 29 ; 440-450.
  31. Jacobzone S E, Cambois, Robine J M. Is the Health of Older Persons in OECD Countries Improving Fast Enough to Compensate for Population Ageing? OECD Economic Studies 2000 ; No 30.
  32. Manton K G. Changing concepts of morbidity and mortality in the elderly population. The Milbank Memorial Fund Quarterly- Health and Society 1982 ; 60(2) ; 183-244. https://doi.org/10.2307/3349767
  33. Martins J O, Maisonneuve C. The Drivers of Public Expenditure on Health and Long-Term Care : An Integrated Approach. OECD Economic Studies No 43 ; 2006.
  34. Michel J P, Robine J M. A New General Theory of Population Ageing. The Geneva Papers On Risk and Insurance 2004 ; 29(4) : 667-678. https://doi.org/10.1111/j.1468-0440.2004.00309.x
  35. OECD. Caring for Frail Elderly People. Social Policy Studies No 477 ; 1996.
  36. OECD. LTC for Older People. The OECD Health Project ; 2005.
  37. OECD. Projecting OECD Health and Long-Term Care Expenditures : What Are The Main Drivers? Economics Department Working Papers No 477 ; 2006.
  38. OECD. Trends in Severe Disability Among Elderly People: Assessing the Evidence in 12 OECD Countries and the Future Implications. OECD Health Working Papers No 26 ; 2007.
  39. OECD. Health Data 2009. Available from: URL: http : //www.sourceoecd.org. 2009.
  40. Reschovsky J D. Demand for and Access to Institutional Long-Term Care: The Role of Medicaid in Nursing Home Markets. Inquiry 1996 : 33 : 15-29.
  41. Waidmann T A, Manton K G. International Evidence on Trends in Disability Among the Elderly. U.S. Department of Health and Human Services-Office of Disability, Aging and Long-Term Care ; 1988.
  42. Wittenberg R, Pickard L, Comas-Herrera A, Davies B, Darton R. Demand for Long-Term Care: Projections of Long-Term Care Finance for Elderly People. London: PSSRU Univ. of Kent ; 1998.