• 한국사회정책
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• 제20권2호
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• pp.195-232
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• 2013

2009년 7월부터 도입된 양육수당은 보육시설을 이용하지 않고 가정 내에서 양육되는 아동에 대한 형평성 차원에서 양육수당이 제공되는 것으로 보육시설을 이용하지 않는 국민기초생활수급자와 차상위 계층 2세 미만 영아에 대해 월 10만 원을 아동양육수당으로 제공하면서 시작되었다. 그러나 2013년에는 소득에 관계없이 만 0~2세의 아동을 대상으로 만 0세 20만 원, 만 1세 15만 원, 만 2~5세 10만 원의 지원금을 제공하기로 개정되었다. 2013년의 이러한 정책변화는 전년도인 2012년의 양육수당 정책과 비교해 볼 때, 760%의 재정 증액이 이루어진 것으로 그 지원의 확대 정도가 이례적으로 매우 큰 것을 알 수 있다. 본 논문에서는 이러한 양육수당의 급격한 확대에 주목하며 양육수당 정책형성과정에 대한 정책네트워크 분석을 시도하였다. 분석 결과, 지방선거, 총선 및 대선이 정책형성 과정 행위자들의 상호작용 및 네트워크 구조 등에 즉각적인 영향을 주었는데, 즉 정당 행위자들은 양육수당의 확대가 정당 행위자들의 이익(선거결과)에 직접적인 영향을 준다고 판단하고 있었다. 이러한 정책경쟁 과정에서 정부부처들과의 예산과 관련된 갈등은 오히려 논의를 다양화시켜 양육수당 논의는 활성화 되었다. 또한 총선 이후 새누리당의 공약에서 시작된 양육수당의 확대는 비슷한 복지 공약 등을 내세운 박근혜 후보가 대통령에 당선되면서 구체적으로 정책채택 단계로 접어들어 정책형성과정과 정책채택과의 밀접한 관계도 확인하였다.

• 한국노년학
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• 제29권1호
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• pp.177-194
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• 2009

본 연구는 일차적으로 노인장기요양보험 급여방식 중 현물급여와 현금급여의 선택에 있어서 비공식 가족수발자들의 현금급여 선호도를 알아보고, 이에 영향을 미치는 요인을 파악함으로써 현금급여 도입의 필요성을 인식하는데 목적이 있다. 이차적으로는 조건부 가치측정법을 이용하여 비공식적 가족수발에 대한 적정 현금급여액을 추정함으로써 미래 현금급여 도입 시 수가산정을 위한 기초 자료로 제시하고자 한다. 본 연구를 위한 조사는 서울시 소재 3차 의료기관 3곳에서 현재 환자를 돌보고 있는 환자의 보호자 300명을 대상으로 하였다. 경증과 중증 두 가지 유형의 가상의 시나리오 및 구조화된 설문지를 제시한 후 현금급여를 수용할 최소한의 보상금액(Willingness-To-Accept, WTA)을 이중경계 양분선택형 질문으로 구하였으며, 일대일 직접 면접법을 이용하였다. 연구결과, 경증노인에 대해서는 52.7%가, 중증노인에 대해서는 26.0%만이 현금급여 서비스를 선호하였다. 경증노인에 대한 적정 현금급여액은 월 평균 62.8만원, 중증 노인에 대한 적정 현금급여액은 월 평균 107.2만원인 것으로 나타났다. 본 연구는 비공식적 수발자가 직면하는 각기 다른 상황에 대한 실제 현금급여 선호도를 확인함으로써 현금급여 도입의 필요성을 인식하였으며, 잠재적 가족수발자들의 시간손실 보상액으로서 수발자가 받아들일 수 있는 주관적 수발비용을 적정 현금급여액으로 추정함으로써 현행 특별현금급여액의 적정성을 평가하는데 보다 현실적인 기준을 마련하였다는데 함의가 있다고 하겠다.

• 보건행정학회지
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• 제19권2호
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• pp.36-50
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• 2009

Korean Government had performed three pilot programs to introduce the long term care insurance system. Persons aged 65 or older who are dependent on others for daily living could use long term care services in the pilot program. The long-term care insurance covered nursing home services, home care services and cash benefits. The cash benefits are included that for elderly at home and for patients in geriatric hospital. This study investigated whether there had been any change in the medical care utilization according to cash benefits for geriatric hospitalization. This study used National Health Insurance claims and Long term Care Insurance claims 2003 through 2006. Data were composed of subjects who undertook both insurance coverage. The subjects was divided into two groups. Case group included participants with the cash benefits of geriatric hospitalization. Control group included persons without the cash benefits selected by random sampling according to the distribution of case group. This study showed that the amount of medical care utilization of the case group is more significantly increased than the control group after adjusted their health condition and functional condition. This result will be helpful for making decisions on whether the cash benefit of geriatric hospitalization can be introduced into long term care insurance system.

• 예술인문사회 융합 멀티미디어 논문지
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• 제7권2호
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• pp.701-710
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• 2017

본 연구는 장애아동이 지원받는 현금급여와 현물급여정책이 주양육자의 서비스 만족도에 미치는 영향에 관하여 연구하였다. 장애아동을 대상으로 한 연구들을 살펴본 결과 주양육자의 양육스트레스, 양육부담 그리고 가족 구성원의 어려움 등에 관하여 연구가 이루어졌다. 그러나, 장애아동에게 지원되는 급여정책에 대한 연구는 미비하게 이루어졌으며, 급여의 유형별로 구분하여 주양육자의 서비스 만족도를 다룬 연구 역시 미비함을 발견하였다. 연구목적을 달성하기 위해 선행연구에서 보고하고 있는 변수(부모성별, 아동성별, 부모연령, 아동연령, 장애등급, 평균소득)가 서비스 만족에 미치는 영향을 살펴보았다. 그 결과 서비스 만족도에 영향을 미치는 주요한 변수는 부모연령, 아동연령, 아동성별이 통계적으로 유의미한 결과가 나타났다. 이는 신청절차, 경제적 부담, 지원 및 선정기준, 서비스량, 전반적 만족에 전반적으로 통계적으로 유의미한 결과를 보였다. 연구결과를 바탕으로 현금급여와 현물급여에 대한 함의는, 급여의 금액과 범위 확대, 장애아동의 연령을 고려한 맞춤형 서비스를 제공함으로써 궁극적으로 주양육자의 서비스 만족도를 높일 수 있을 것이다.

• 보건행정학회지
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• 제20권3호
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• pp.104-122
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• 2010

Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.

• 보건행정학회지
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• 제17권1호
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• pp.75-93
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• 2007

This research purposed to analyse the diversity of the long-term care system based on the dependency/independency of the aged. For this purpose, we divided the long-term care systems to three components; form of benefit, generosity of benefit and delivery system. Form of benefit is whether the benefit is cash or in-kind, and the generosity of benefit is related to the level and coverage of benefit. The last concerned to focus on provider and user selection. According to this, we tried to make an ideal type of long-term care in the perspective of citizenship and consumerism. As a result, we established four types of long-term care system; active citizen type, passive citizen type, latent citizen type, and family dependent type. And we investigated Austria, Sweden, Germany and Korea for each type empirically.

• 보건행정학회지
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• 제31권1호
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• pp.5-16
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• 2021

Both access to healthcare services and income security in case of personal illness are being needed to achieve universal health coverage, which is enshrined in the human rights to health and social security and international standards on social protection. Income security acts on both the social determinants and the adverse consequences of ill health and thus would break the vicious disease-poverty cycle. The government is supposed to implement a demonstration project of sickness benefit in 2022 and to publicize its more specific blueprint for all workers. This study is to suggest basic principles and a framework to design a new sickness benefit for universal health coverage, which is based on reviews on previous studies, related issues, and institutional conditions. This is to provide a theoretical basis to promote further discussion and to support its decision-making.

• 한국병원경영학회지
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• 제11권3호
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• pp.19-41
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• 2006

The Objective of this study was to design the model which predict the future cash flow of hospitals and on the basis of designed model to support sound hospital management by the prediction of future cash flow. The five cash flow measurement variables discussed in financial accrual part were used as variables and these variables were defined as NI, NIDPR, CFO, CFAI, CC. To measure the cash flow B/S related variables, P/L related variables and financial ratio related variables were utilized in this study. To measure cash flow models were designed and to estimate the prediction ability of five cash flow models, the martingale model and the market model were utilized. To estimate relative prediction outcome of cash flow prediction model and simple market model, MAE and MER were used to compare and analyze relative prediction ability of the cash flow model and the market model and to prove superiority of the model of the cash flow prediction model, 32 Regional Public Hospital's cross-section data and 4 year time series data were combined and pooled cross-sectional time series regression model was used for GLS-analysis. To analyze this data, Firstly, each cash flow prediction model, martingale model and market model were made and MAE and MER were estimated. Secondly difference-test was conducted to find the difference between MAE and MER of cash flow prediction model. Thirdly after ranking by size the prediction of cash flow model, martingale model and market model, Friedman-test was evaluated to find prediction ability. The results of this study were as follows: when t-test was conducted to find prediction ability among each model, the error of prediction of cash flow model was smaller than that of martingale and market model, and the difference of prediction error cash flow was significant, so cash flow model was analyzed as excellent compare with other models. This research results can be considered conductive in that present the suitable prediction model of future cash flow to the hospital. This research can provide valuable information in policy-making of hospital's policy decision. This research provide effects as follows; (1) the research is useful to estimate the benefit of hospital, solvency and capital supply ability for substitution of fixed equipment. (2) the research is useful to estimate hospital's liqudity, solvency and financial ability. (3) the research is useful to estimate evaluation ability in hospital management. Furthermore, the research should be continued by sampling all hospitals and constructed advanced cash flow model in dimension, established type and continued by studying unified model which is related each cash flow model.

• 가정과삶의질연구
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• 제33권1호
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• pp.87-97
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• 2015

This study aims to examine how home child care allowance influences a mother's choice of child care type. To accomplish this goal, we surveyed 432 mothers who had at least one child under 5 years old. The data were analyzed by frequencies, percentages, means and binomial logistic regressions. The results showed that unemployed mothers and mothers with younger children had a high tendency to choose home child care allowance instead of child care subsidy. Second, mother's employment status, age of first child and an interactive term of mother's employment status and home child care receipt influenced a concordance between an ideal and actual child care type. Unemployed mothers and mothers with younger children were more likely to experience a concordance between their ideal and actual types of child care. By investigating how home child care allowance affects the right of choice in child care type, this study provides empirical information to policy makers and researchers and contributes to develop cash-benefit policies for families with young children.

• 보건행정학회지
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• 제33권3호
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• pp.325-337
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• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.