• 제목/요약/키워드: Social Insurance Costs

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가구의 이동결정에 관한 개념적고찰 (A Conceptual Analysis of Household Migration Decisions)

  • 김헌민
    • 한국인구학
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    • 제14권1호
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    • pp.26-34
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    • 1991
  • Migration studies that assume that decision making is done on an individual basis is overlooking the importance of the family factor. Considering that must people belong to families, it is more appropriate to view migration decision from the perspective of the family. This study analyzes the household migration decision whereby the alternatives are to stay, 10 undertake family migration or to undertake single migration of a member. In developing a conceptual model of household migration decision, it is assumed that the household's objective is to maximize household income which is a function of individual members' earnings. The benefits and costs of household migration and individual migration are identified and the household chooses the migration strategy that maximizes expected household income. When household members have conflicting earning prospects in the potential destination, the household considers single migration of the member with the best earning potentials. However, lone migration by a household member involves cost of family separation which is both monetary and psychic, and this study shows that lone migration is undertaken only when its net gains to the family are greater than the separation cost of the family. The major benefit of choosing single migration is the retention of home base in the place of origin which can serve as an insurance against the uncertainty of obtaining a job in the destination, the benefit that is unavailable in family migration. The conceptual analysis shows how a household's migration decision would depend on its members' economic roles and prospects in the destination. Besides the economic variables, social and life cycle variables of the family translate into separation costs and benefits of migration. This study indicates that one - earner family in low economic status but with good earning prospects and high separation costs is more likely to choose family migration over single migration.

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장기요양보호서비스의 비용분석 (Cost Analysis of Long Term Care Services)

  • 박창제;김수영;주수현
    • 한국노년학
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    • 제29권3호
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    • pp.1043-1061
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    • 2009
  • 본 연구의 목적은 현재 실시되고 있는 장기요양보호서비스에 대하여 유형별로 비용측면에서 경제성을 분석하고 정책적 함의를 논의하는 것이다. 조사대상자는 2008년 7월부터 시행되고 있는 노인장기요양제도의 적용대상자로 인정받은 65세 이상 노인과 그 부양가족이었고, 주부양자를 대상으로 요양보호서비스유형별로 구분하여 설문조사하였다. 회수된 설문지 중에서 방문요양 155부, 방문간호 67부, 요양시설 108부, 요양병원 92부 총 422부가 본 연구의 분석 표본으로 사용되었다. 조사결과 다음과 같은 사실을 확인할 수 있었다. 첫째, 부양 가계의 가계소득이 높지 않았다. 둘째, 장기요양보험제도가 실시되고 있음에도 불구하고 노인부양가계가 노인을 위하여 직접 지불하는 금액이 여전히 높은 편이다. 셋째, 부양가계가 노인을 위하여 수발하는 데 소요되는 간접비용이 아주 높은 편이다. 특히 재가서비스인 방문요양의 경우엔 평균 756,947원, 방문간호인 경우 594,807원으로 시설서비스에 비하여 간접비용이 상대적으로 아주 더 높았다. 넷째, 장기요양보호 노인에 대한 사회적 비용이 아주 높다. 이 금액은 본 조사에서 확인한 부양가계의 평균가계소득과 비슷한 수준이다. 다섯째, 요양보호서비스 유형별로 부양가계가 부담하는 서비스 비용에서 유의한 차이를 보였다. 여섯째, 부양가계의 직접 비용에서도 요양보호서비스 유형별로 유의한 차이를 보였지만 서비스이용비용보다는 그 차이가 작았다. 일곱째, 사회적 직접 비용은 요양보호서비스 유형별로 아주 유의한 차이를 보였다. 여덟째, 요양보호서비스를 이용하는 노인에 대한 사회적 비용금액이 아주 크고 서비스 유형별 총 사회적 비용이 전체 서비스 이용노인의 평균적인 사회적 비용에 수렴하는 경향을 보였다.

노인장기요양보험의 보험수리적 분석 (Actuarial Analyses of Long Term Care Insurance for the Elderly in Korea)

  • 권혁성
    • 응용통계연구
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    • 제26권5호
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    • pp.725-736
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    • 2013
  • 최근 노년기의 삶에 대비하기 위한 은퇴자금 마련이 중요한 개인적, 사회적 문제로 부각되고 있다. 특히, 앞으로 노년인구의 비율이 지속적으로 상승할 것이라는 전망과 더불어 이러한 개인의 재무설계 및 그와 관련한 리스크와 관련한 문제는 그 중요성이 날로 커질 것이다. 노년기의 질병에 따른 의료비 지출은 특히 재무적인 리스크와 밀접한 관련이 있는데, 유병 기간이 상대적으로 긴 질병의 경우에는 수발비용을 포함한 장기적인 의료비 지출로 인하여 재무적인 위험을 증가시키고 노년기의 삶의 질을 크게 떨어뜨릴 수 있다. 따라서, 각 개인이 장기적인 비용 지출을 요하는 질병에 대하여 예상되는 비용의 규모를 파악하고 이를 사전에 대비할 수 있는 방안을 모색하는 것이 필요하다. 본 연구에서는 노인장기요양보험의 실적 자료와 다중상태모형을 토대로, 노년기에 노인장기요양보험을 통하여 장기요양보호가 필요한 기간과 이에 따른 비용 규모의 추정을 통하여, 각 개인이 장기간병을 위해 준비해야 하는 필요금액을 도출하여 보았다.

소득 계층별 의료비 부담의 추이와 정책과제 (Changes in financial burden of health expenditures by income level)

  • 김태일;허순임
    • 보건행정학회지
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    • 제18권4호
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    • pp.23-48
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    • 2008
  • Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.

보건의료 빅데이터를 이용한 얼굴마비환자의 의료비용에 관한 연구 (Medical costs for patients with Facial paralysis : Based on Health Big Data)

  • 홍민정;엄태웅;김신아;김남권
    • 대한한의학회지
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    • 제36권3호
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    • pp.98-110
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    • 2015
  • Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

Socioeconomic Impact of Cancer in Member Countries of the Association of Southeast Asian Nations (ASEAN): the ACTION Study Protocol

  • Kimman, Merel;Jan, Stephen;Kingston, David;Monaghan, Helen;Sokha, Eav;Thabrany, Hasbullah;Bounxouei, Bounthaphany;Bhoo-Pathy, Nirmala;Khin, Myo;Cristal-Luna, Gloria;Khuhaprema, Thiravud;Hung, Nguyen Chan;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권2호
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    • pp.421-425
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    • 2012
  • Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.

Effectiveness of Community-based Case Management for Patients with Hypertension

  • Yun, Soon-Nyoung;Lee, In-Sook;Kim, Jin Hyun;Ko, Young
    • 지역사회간호학회지
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    • 제25권3호
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    • pp.159-169
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    • 2014
  • Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

Identification of Unmet Healthcare Needs: A National Survey in Thailand

  • Chongthawonsatid, Sukanya
    • Journal of Preventive Medicine and Public Health
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    • 제54권2호
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    • pp.129-136
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    • 2021
  • Objectives: This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand. Methods: The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis. Results: Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors. Conclusions: Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

피보험자 건강진단의 비용-편익 분석 (Cost-benefit Analysis of Health Screening Test for the Insured)

  • 유승흠;손명세;조우현;박은철;이영두;이규식;전기홍
    • Journal of Preventive Medicine and Public Health
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    • 제22권2호
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    • pp.248-258
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    • 1989
  • As a result of cost-benefit analysis by making a macroscopic approach to the health screening projects conducted 4 times since 1950 for the insured people of the Korea Medical Insurance Corporation, the following conclusions were reached. 1. The direct costs put into the health screening project, and the time costs which were paid by examinees or calculated in terms of social costs have been estimated. The results is that the lowest estimation was 10,337 million won and the highest 15,141 million won when a minimum of 1.5 hours of time spent and a maximum 4 hours were applied. 2. In terms of the psychiatric benefits, the lowest estimation was 5,341 million won while the highest was 5,585 million won. 3. In terms of the benefits for each kind of diseases, the lowest estimation of 37,188 million won and highest estimation of 74,383 million won have been calculated for the liver diseases. And for the cardiovascular diseases, the minimum estimation was 14,475 million won while the maximum was 20,532 million won. In case of pulmonary tuberculosis, with external effect benefits being included, the estimation ranged from the minimum of 1,649 million won to the maximum of 1,832 million won. And the estimation of benefits for diabetes mellitus and renal diseases ranged from 89 million won to 92 million won and from 4,567 million won to 7,598 million won respectively. 4. In comparing costs and benefits, as a results of comparing each highest and lowet estimation a range of minimum 46,708 million won and maximum 98,071 million won of benefits has been gained.

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의료 빅데이터를 활용한 CRM 기반 건강예보모형 설계 (Design of Health Warning Model on the Basis of CRM by use of Health Big Data)

  • 이상원;신성윤
    • 한국정보통신학회논문지
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    • 제20권8호
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    • pp.1460-1465
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    • 2016
  • 오늘날 많은 비용이 국가 의료보장체계의 유지를 위협하고 있다. 국가 질병 통제 및 방지 센터의 감사체계를 동반한 건강관리 역학성에 대한 연구에도 불구하고, 시간 한계, 표본 한계, 대상 질병 한계에 대한 제약이 여전히 존재하고 있다. 이러한 배경에서, 방대한 양의 전수 데이터를 활용하여, 많은 기술들이 건강의 선제적 예측이나 그 대상 질병을 확장하는 분야에 충분하게 적용되고 있다. 우리는 국민건강보험의 구조적 데이터와 소셜네트워크서비스의 비구조적 데이터를 활용하여 질병을 예측하는 모형을 설계하였다. 이 모형은 건강예보서비스를 제공함으로써, 국민건강을 증진시키고 사회적 혜택을 극대화할 수 있다. 또한, 빅데이터 분석에 근거하여, 건강보험비용의 갑작스러운 증가를 감소시키거나 적시적인 질병발생을 예측할 수도 있다. 관련된 의료 예측 사례를 살펴보았고, 제안된 모형의 검증을 위하여 시범과제를 통한 실험을 수행하였다.