DOI QR코드

DOI QR Code

노인장기요양보험제도가 노인진료비에 미치는 영향

Effect of the Long-term Care Insurance Policy on Medical Expenditures for the Elderly

  • 한남경 (연세대학교 보건대학원) ;
  • 정우진 (연세대학교 보건대학원) ;
  • 김노을 (연세대학교 보건정책 및 관리연구소) ;
  • 임승지 (국민건강보험공단 건강보험정책연구원) ;
  • 박종연 (한국보건의료연구원)
  • Han, Nam-Kyung (Graduate School of Public Health, Yonsei University) ;
  • Chung, Woojin (Graduate School of Public Health, Yonsei University) ;
  • Kim, Roeul (Institute of Health Services Research, Yonsei University) ;
  • Lim, Seungji (Health Insurance Policy Research Institute, National Health Insurance Corporation) ;
  • Park, Chong-Yon (National Evidence-based Healthcare Collaborating Agency)
  • 투고 : 2013.02.19
  • 심사 : 2013.04.20
  • 발행 : 2013.06.30

초록

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

키워드

참고문헌

  1. Statistics Korea. Social survey in Korean of 2009. Daejeon: Statistics Korea; 2010.
  2. Statistics Korea. Statistics yearbook of the recent changes in population. Daejeon: Statistics Korea; 2009.
  3. Park JY, Kang IO, Kim KH, Seo SL, Shin JY. Policy alternatives of healthcare systems for the elderly in Korea. Seoul: National Health Insurance Service; 2005.
  4. Lee YH. A political problem of the long-term care for the aging society. Seoul: National Health Insurance Service; 2004.
  5. Moon HP, Kim DS, Yoon HS, Park CK, Lee SH, Lee SS, et al. Socioeconomic impact of population aging and policy issues. Seoul: Korea Development Institute; 2006.
  6. Shin HW. Forecasting health expenditure with the application to the Korea's national health insurance system and political problem. Health Welf Issue Focus 2009;(3):1-7.
  7. Chung W. Population aging and health care: stochastic forecasting health expenditure with the application to the Korea's national health insurance system and the government budget allocation in demographical change for the aging society. Seoul: Korea Development Institute; 2005.
  8. National Health Insurance Service. Statistics yearbook of the national health insurance. Seoul: National Health Insurance Service; 2009, 2010, 2012
  9. Bae SI, Lee SM, Kim KH. Analysis of the influence of finance depending on the changes of working-age population. Seoul: National Health Insurance Service; 2009.
  10. Lee KJ. Long-term care insurance system for the elderly. Goyang: Knowledge Community; 2007.
  11. Bae SI, Lee SM, Kim KH. Impact of implementing the long-term care insurance for the elderly on the medical fee. Seoul: National Health Insurance Service; 2009.
  12. Tetsuro C. Variations in medical expenses for the elderly and the economic issues. Okayama Econ Rev 2007;38(4):21-38.
  13. Jhun GJ. Changes in medical fee and utilization of services before and after the introduction of the long-term health insurance for the elderly: focused on demographic, sociologic and physical characteristics [master's thesis]. Seoul: Yonsei University; 2010.
  14. Anderson R, Newman JF. Societal and individual determinants of medical care utilization In the United States. Milbank Mem Fund Q Health Soc 1973;51(1):95-124. https://doi.org/10.2307/3349613
  15. Moffitt R. Program evaluation with nonexperimental data. Eval Rev 1991;15(3):291-314. https://doi.org/10.1177/0193841X9101500301
  16. Lach S. Do R&D subsidies stimulate or displace private R&D?: evidence from Israel. J Ind Econ 2002;50(4):369-390. https://doi.org/10.1111/1467-6451.00182
  17. Kim SS. The effects of government R&D subsidies on private R&D investment, determinants of low fertility among Korean women: the case of Korean industry after 2000[dissertation]. Seoul: Seoul National University; 2008.
  18. National Health Insurance Service. Major statistics of the national health insurance in the first half of 2010. Seoul: National Health Insurance Service; 2010.
  19. Park JY, Lee YH, Kwon JH, Lee EM, Lee HY, Kim YH. The development of an integrated care model for the long-term care and medical service. Seoul: National Health Insurance Service; 2010.
  20. Choi ID, Park JY, Lee EM. The establishment of efficient delivery system for the connection of medical service and long-term care. Seoul: National Health Insurance Service; 2009.

피인용 문헌

  1. Does long-term care insurance reduce the burden of medical costs? A retrospective elderly cohort study pp.14441586, 2018, https://doi.org/10.1111/ggi.13536