분석심사 선도사업에 대한 의사들의 인식과 평가
Physicians’ Perception and Evaluation of the Health Insurance ReviewPilot Project in Korea
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The purpose of this study is to derive policy implications for the government's health insurance review system reform by analyzing physicians' perceptions and evaluation levels of the health insurance review pilot project. Total 4,022 data was extracted from the 2020 Korean Physician Survey(KPS) of the Korean Medical Association(KMA). The descriptive statistics, Chi-square test and multiple regression analysis were conducted for data analysis. The results show that of the total 4,022 physicians, only 7.2% were aware of the government's pilot project, and 39.8% had a positive evaluation of this project. Men were more negative about the pilot project than women(OR=1.26, p<.0.01) The younger the age, the more negatively they evaluated the pilot project(p<0.001). Self-employed physicians were more negative about the pilot project than professors(OR=2.12, p<0.001). Physicians working in clinics(OR=1.32, p<0.05) or hospitals(Or=1.42, p<0.05) evaluated the pilot project more negatively than physicians working in tertiary general hospitals. Physicians working in the private sector had a negative evaluation of the pilot project than physicians working in the public sector(OR=1.30, p<0.05). Finally, physicians who were the target of the pilot project evaluated it more negatively than the physicians who were not(OR=1.24, p<0.05). Policy authorities need to understand the opinions of physicians in reforming health insurance review system, and establish the direction of the review system through sufficient discussion and communication with interested parties.
Abstract
The purpose of this study is to derive policy implications for the government's health insurance review system reform by analyzing physicians' perceptions and evaluation levels of the health insurance review pilot project. Total 4,022 data was extracted from the 2020 Korean Physician Survey(KPS) of the Korean Medical Association(KMA). The descriptive statistics, Chi-square test and multiple regression analysis were conducted for data analysis. The results show that of the total 4,022 physicians, only 7.2% were aware of the government's pilot project, and 39.8% had a positive evaluation of this project. Men were more negative about the pilot project than women(OR=1.26, p<.0.01) The younger the age, the more negatively they evaluated the pilot project(p<0.001). Self-employed physicians were more negative about the pilot project than professors(OR=2.12, p<0.001). Physicians working in clinics(OR=1.32, p<0.05) or hospitals(Or=1.42, p<0.05) evaluated the pilot project more negatively than physicians working in tertiary general hospitals. Physicians working in the private sector had a negative evaluation of the pilot project than physicians working in the public sector(OR=1.30, p<0.05). Finally, physicians who were the target of the pilot project evaluated it more negatively than the physicians who were not(OR=1.24, p<0.05). Policy authorities need to understand the opinions of physicians in reforming health insurance review system, and establish the direction of the review system through sufficient discussion and communication with interested parties.
참고문헌 (22)
- 심사평가원, 심사･평가 시스템 개편 추진, "건강보험심사평가원", 건강보험심사평가원, ~ (2017)
- 심사평가체계 개편을 위한 분석심사 선도사업 지침 개정안, "건강보험심사평가원", 건강보험심사평가원, ~ (2020)
- 현행 심사(운영)체계 개선 2020년 실행계획, "건강보험심사평가원", 건강보험심사평가원, ~ (2020)
- 건강보험 계약제의 도입방안, "김계현", 의료정책연구소, ~ (2008)
- 심사평가체계 개편방안 검토, "김계현", 의료정책연구소, ~ (2019)
- 김운묵, "건강보험 진료비 청구 및 심사지급에서의 권리분쟁과 구제", 의료법학, 8(2), pp.119~164 (2007)
- 민인순, "의원 외래환자 건강보험 진료비 청구에서 심사조정률에 영향을 미치는 요인", 대한의사협회지, 53(11), pp.1017~1027 (2010), 대한의사협회
- 박선미, "건강보험 진료비 심사 기준에 대한 의사 인지도 조사 연구", 석사, 보건정책및병원관리학, pp.2005
- 진료비 청구경향 심사제 도입방안 연구, "양정희", 근로복지공단 산재보험연구센터, ~ (2011)
- 분석심사 선도(시범)사업 개선사항 도출을 위한 연구, "윤석준", 고려대학교 산학협력단, ~ (2021)
- 새로운 제도도입을 위한 동료심사제도 연구, "이석현", 대한의사협회, ~ (2004)
- 건강보험 적정성 평가정책의 문제점과 개선방안, "이선희", 의료정책연구소, ~ (2006)
- 2016 전국의사조사, "이정찬", 의료정책연구소, ~ (2017)
- 2020 전국의사조사, "이정찬", 의료정책연구소, ~ (2021)
- 경기도 시범사업 운영체계 개선방안, "이학연", 경기연구원, ~ (2022)
- 임금자, "2011년 의원의 경영실태 조사 분석", 대한의사협회지, 55(4), pp.390~403 (2012), 대한의사협회[DOI]
- 임도빈, "정책이해도가 정책성과 인지도에 미치는 영향에 관한 연구", 한국거버넌스학회보, 19(2), pp.1~29 (2012), 한국거버넌스학회[DOI]
- 이삼열, "시범사업에 관한 탐색적 연구: 보건복지가족부 사업을 중심으로", 행정논총, 47(4), pp.279~305 (2009), 한국행정연구소
- 장용석, "건강보험중 구강요양급여의 청구 및 심사에 관한 치과의사의 견해", Journal of Oral Medicine and Pain, 30(2), pp.215~230 (2005), 대한안면통증∙구강내과학회
- 조희숙, "진료비 심사제도에 대한 개원의들의 태도 및 만족도", 병원경영학회지, 10(2), pp.45~63 (2005), 한국병원경영학회
- 김계현, "The Gap Between Physicians and the Public in Satisfaction with the National Health Insurance System in Korea", Journal of Korean Medical Science, 27(6), pp.579~585 (2012), 대한의학회[DOI]
- Stoddard JJ, "Managed care, professional autonomy, and income: effects on physician career satisfaction", J Gen Intern Med, 16, pp.675~684 (2001)