건강보험 보장성 강화 정책에 대한 진료비중심 대안의 비교 및 실증 연구
An Empirical study on benefit plans of the National Health Insurance system between the expansion of the benefit for diseases and the expansion of the benefit for medical expenditure
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
The national health insurance act was initiated in 1977. This act has maintained the low burden & low benefit' policy. Also, the low coverage rate did not seem to be solved due to the shortage of the finance. To fix the low coverage rate of the national health insurance, the government introduced a new plan in 2005. The plan was set a goal to increase the coverage rate as the average level developed countries had. The government suggested a benefit plan based on the expansion of the benefit for diseases. However, this plan was criticized by many because high risk patients could not have enough benefits when they had diseases the new list in the expansion of the benefit for diseases was not held. This study suggested the expansion of the benefit for medical expenditure as an alternative way in order to increase the coverage rate. This study compared the coverage rate of the patients with high cost when the same amount of money applied to two different benefit plans. The medical security for patients with high cost was good when the out-of-pocket payment of limit system, one way for the expansion of the benefit for medical expenditure, was expanded. The expansion of the out-of-pocket payment of limit system is a proper way for increasing the coverage rate of the national health insurance.
Abstract
The national health insurance act was initiated in 1977. This act has maintained the low burden & low benefit' policy. Also, the low coverage rate did not seem to be solved due to the shortage of the finance. To fix the low coverage rate of the national health insurance, the government introduced a new plan in 2005. The plan was set a goal to increase the coverage rate as the average level developed countries had. The government suggested a benefit plan based on the expansion of the benefit for diseases. However, this plan was criticized by many because high risk patients could not have enough benefits when they had diseases the new list in the expansion of the benefit for diseases was not held. This study suggested the expansion of the benefit for medical expenditure as an alternative way in order to increase the coverage rate. This study compared the coverage rate of the patients with high cost when the same amount of money applied to two different benefit plans. The medical security for patients with high cost was good when the out-of-pocket payment of limit system, one way for the expansion of the benefit for medical expenditure, was expanded. The expansion of the out-of-pocket payment of limit system is a proper way for increasing the coverage rate of the national health insurance.
참고문헌 (25)
- 강선희, "고액진료비 환자의 특성 비교분석", 한국의료 QA학회지, 2(2), pp.112~129 (1995)
- 김주경, "건강보험 급여확대의 우선순위 설정에 대한 연구", 박사, pp.2004
- 2007 건강보험 보장성 수준 및 달성전략, "권순만", 국민건강보험공단, ~ (2007)
- 구미경, "고액진료환자의 특성분석", 건강보험포럼, 2(1), pp.33~48 (2003)
- 문옥륜, "의료보험 고액진료비 환자의 특성연구", 보건행정학회지, 3(1), pp.53~83 (1993)
- 건강보험 보장성 강화방안, "보건복지부", ~ (2005)
- 서태봉, "건강보험 중증질환 급여 확대의 효과측정에 관한 연구 - 심장병 수술 환자 사례를 중심으로 -", 석사, pp.2006
- 임준, "사회안전망으로서 건강보험 보장성 강화방안", 건강보험포럼, 4(3), pp.37~50 (2005)
- 유원섭, "중증질환 보험급여 현황과 정책과제", 건강보험포럼, 4(4), pp.24~44 (2005)
- 보장성 확대정책으로 살펴본 건강보험 관련 의사결정과정의 문제점, "윤희숙", ~ (2007)
- 효율적 의료보장체계 구축을 위한 민영건강보험 활성화 방안, "정기택", 생명·손해보험협회, ~ (2006)
- 정형선, "건강보험 기본급여의 우선순위", 보건행정학회지, 14(2), pp.34~57 (2004), 한국보건행정학회
- 정형선, "의료보장성 및 의료보장 실효급여율에 관한 연구", 보건경제와 정책연구, 10(1), pp.95~112 (2004)
- 정형선, "의료보장성지표의 재구성과 2003년 지표의 생산", 보건경제와 정책연구, 11(1), pp.141~153 (2005)
- 조병희, "건강보험 보장성 강화 접근방법", 국민건강보험공단 세미나 발표자료, pp.30~44 (2005)
- 최숙자, "계층적분석법(AHP)을 이용한 건강보험급여확대상병 우선순위 결정", 보건행정학회지, 16(1), pp.73~94 (2006), 한국보건행정학회
- 건강보험 적정 보장성 확보방안, "허순임", 한국보건사회연구원, ~ (2007)
- Annie P. Michaelis, "Priority-setting ethics in public health", Journal of Public Health Policy, 23(4), pp.399~412 (2002)
- Berg M, "Reasonable rationing: International Experience of Priority Setting in Health Care" (2003), Open University press
- Chris Ham, "Reasonable rationing: International Experience of Priority Setting in Health Care" (2003), Open University press
- Deber R, "The public-private mix in health care", National Forum on Health, 4, pp.423~545 (1998)
- Norrheim OF, "Reasonable Rationnig: International Experience of Priority Setting in Health Care" (2003), Open University press
- Martin D, "Reasonable rationing: International Experience of Priority Setting in Health Care" (2003), Open University press
- OECD Health Data, "OECD", ~ (2006)
- Richard Cookson, "Principles of justice in health care rationing", Journal of Medical Ethics, 26(5), pp.323~329 (2000)
