• Title/Summary/Keyword: 본인부담금

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Analyses of Impacts of the Outpatient Cost Sharing Reduction based on the Difference-in-differences Model (이중차이모델에 의한 건강보험 외래본인부담금 경감제도의 영향 분석)

  • Ahn, Lee-Su
    • The Journal of the Korea Contents Association
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    • v.13 no.11
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    • pp.187-197
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    • 2013
  • Objectives : The purpose of this study was to analyze the effect of outpatient cost sharing reduction on health care utilization of children under 6 years old. Methods : The data in this analysis was the health insurance claims data between August 2006 and July 2008. The study group was divided into two age groups, namely 0-5 years old and 6-10 years old. This study evaluated the impact of policy change on office visits per person and expenditure per visit. In order to do so, the double difference analysis is used. Results: The results showed that outpatient cost-sharing reduction has never really had a huge impact on office visits per person and expenditure per visit. Conclusions: This study showed that the outpatient cost sharing reduction for children under 6 years old policy is not working. Therefore, cost sharing of National Health Insurance by income class is needed.

The Effect of Private Health Insurance on the Subjective Burden of Medical Expenses (민간의료보험 가입 여부가 본인부담 진료비의 주관적 부담 수준에 미치는 영향)

  • Hong, Jin Hyuk;Noh, Jin-Won;Park, Kisoo;Lee, Yejin;Kwon, Young Dae
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.63-70
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    • 2017
  • Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

Some Adults' Opinions about Private Dental Insurance and National Dental Insurance according to Stress of Dental Treatment Cost (일부 성인의 치과진료비 부담에 따른 치과 건강보험 확대 및 민영치과보험 가입 의사)

  • Kim, Youn-Gyung;Kim, Eun-Ji;Nho, Su-Hyun;Baek, Eun-Jin;Shin, Min-Seo;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.15 no.6
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    • pp.703-711
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    • 2015
  • The high dental treatment cost has been considered as one of the major reasons for inappropriate dental treatment in Korea. The aim of this study was to investigate the opinions of expansion of National Health Insurance (NHI) in dental treatment fields not covered with NHI and buying private dental insurance. This survey was carried out targeting 266 adults from their 30s to 50s with convenience sampling. The higher orders in stress of dental treatment cost were orthodontic treatment, dental implant, prosthodontic treatment, and caries treatment not covered with NHI. The higher orders in needs of expansion of NHI were caries treatment not covered with NHI, prosthodontic treatment, and orthodontic treatment. The agreement percentages with age restriction in NHI were scaling 57.1%, denture 23.3%, implant 14.3%, respectively. The subjective oral health had impact on the stress of dental treamtent cost and expansion on NHI. Although only 8.3% subjects had private dental insurance, 68.4% of the subjects had positive opinions buying private dental insurance. The correlation coefficients between stress of dental treatment cost and buying private dental insurance were implant 0.408, caries treatment not covered with NHI 0.404, denture 0.394, crown and bridge 0.375, and orthodontic treatment 0.313. Expansion of NHI in dental treatment and development of private dental insurance was suggested to treat dental disease in appropriate time.

현존 세계 최고 금속활자본 '직지' 문화가치 8694억원

  • Korean Printers Association
    • 프린팅코리아
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    • s.23
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    • pp.82-85
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    • 2004
  • 현존하는 세계 최고의 금속활자본인 직지심체요절의 문화적 자산가치는 8694억원이라는 조사결과가 나왔다. 충북개발연구원(원장 이태열)은 최근 '직지의 가치추정 및 활용방안'이라는 연구보고서를 통해 "비시장 재화에 대한 화폐가치를 평가하는 조건부 가치측정(CVM) 방식으로 직지의 가치를 조사한 결과 이같이 추정됐다"고 밝혔다. 조건부 가치측정이란 환경과 문화, 관광자원 등 거래가 되지 않는 재화에 대한 가치를 평가하는 방법 중 하나로, 이번 조사에 제시된 조건은 '직지의 보전 및 세계화에 부담금을 낸다면 얼마를 낼 용의가 있는가'였다. 전국 340여명의 표본조사 응답자들은 이 질문에 44.4%(151명)가 '부담 의사있다'고 답변했고, 부담금은 5년간 매년 1만840원이 적정할 것이라고 말했다. 연구원 측은 이를 근거로 전국 가구 수에 적용할 경우 직지의 문화적 총자산가치는 8694억원에 달할 것으로 추정했다. 다음은 이번 보고서의 주요 내용을 요약한 것이다.

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The Effects of the Revised Elderly Fixed Outpatient Copayment on the Health Utilization of the Elderly (노인외래정액제 개선이 고령층의 의료이용에 미친 영향)

  • Li-hyun Kim;Gyeong-Min Lee;Woo-Ri Lee;Ki-Bong Yoo
    • 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.

Interaction between Out-of-Pocket Maximum and Indemnity Health Insurance (본인 부담상한제와 민영 실손의료보험의 상호작용)

  • Young-Hee Nam
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.3
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    • pp.667-673
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    • 2024
  • This study aims to diagnose the issues arising from the relationship between the out-of-pocket maximum in health insurance and private indemnity health insurance and propose policy tasks for institutional improvement. Through literature research, the study analyzed the damage to consumers caused by the non-payment of refunds exceeding the out-of-pocket maximum and the changing role of indemnity insurance due to the strengthening of health insurance coverage. The results confirmed that unilateral interpretation of insurance clauses and incomplete sales practices infringe upon consumer rights, and that insurance premiums do not decrease despite the reduction in coverage of indemnity insurance. Therefore, the study emphasized the urgency of institutional improvements such as rationalization of product structure, transparency of risk rate calculation, and reinforcement of consumer information provision, as well as the need for social consensus on the rational division of roles between health insurance and private insurance. This study is significant in that it provides policy implications for the developmental reorganization of the healthcare system.

Study on Out-of-pocket Money among Medical Expenses of an Oriental Medical University Hospital (한방의료의 본인부담금 연구)

  • Shin Sang-Moon;Kang Sung-Wook
    • Journal of Society of Preventive Korean Medicine
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    • v.3 no.1
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    • pp.67-82
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    • 1999
  • This study was performed to investigate out-of-pocket money among medical expenses of an oriental medical university hospital by the use of internal data of an oriental hospital because medical insurance program data could not show us insuree's out-of-pocket money among medical expenses. The purpose of this study was to analyze out-of-pocket money among medical expenses of ambulatory and hospitalized patients. Under this purpose, We analyzed actual medical expenses data of 1389 out-patients and 858 in-patients of the oriental medical university hospital with 90 beds that could be approach to internal data from July 1, 1998 to March 31, 1999. The major findings are as follows : 1. In ambulatory patients, the cost share ratio of insuree & that of insurer was 90 : 10 respectly. 2. In hospitalized patients, the cost share ratio of insuree & that of insurer was 72 : 28 respectly.

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National Health Insurance System of Korea: Resource-Based Relative Value Scale and a New Healthcare Policy (우리나라의 건강보험 수가 시스템: 상대가치 그리고 새로운 건강보험 보장성 강화 대책)

  • Joon-Il Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1024-1037
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    • 2020
  • The resource-based relative value scale (RBRVS) compares the value of a medical practice to the consumption of resources, which consist of the work of the physician, practice expenses, and professional liability insurance. At the time of the 2nd revision of RBRVS, the fee for radiological examinations had been reduced due to the high preservation rate. In RBRVS, practice expenses account for most of the compensation of radiological examinations, and physicians' work is relatively undervalued. A new healthcare policy (Moon Jae-In care) consists of the expansion of the National Health Insurance (NHI) coverage, reduction of patient charges for the vulnerable class, and support for catastrophic medical expenses. However, Moon Jae-In care is expected to negatively affect the NHI in Korea financially. The expansion of the insurance coverage for ultrasonography and MRI examinations is a significant part of the Moon Jae-In care, and radiological societies should establish fair compensations for physicians' work within the field of radiology while implementing the Moon Jae-In care.

Influence of Usual Source of Care on Outpatient Visit and Expense of Hypertension Patients (상용치료원 보유여부가 고혈압 환자의 외래이용횟수 및 외래의료비에 미치는 영향)

  • Yoon, Hyo Jung;Choi, Jae Woo;Lee, Sang Ah;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.22 no.1
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    • pp.1-9
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    • 2017
  • Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.