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건강보험 본인부담금 면제 정책 효과성 분석:6세 미만 아동 입원을 중심으로

The effect of the cost exemption policy on health insurance:Evidence from hospitalized children under 6 years old

김지혜
한국응용경제학회|2017.06|응용경제 (Korea Review of Applied Economics)|제19권 제2호|pp. 5-39

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건강보험Health InsuranceHealth Policy본인부담금보건정책6세 미만 아동 입원정책Cost Exemption Policy for Hospitalized Children under 6 Years OldPatient’s Responsibility Payment Cost-Sharing
주제분류경제학

초록

본 연구는 건강보험 본인부담금 면제 정책의 효과성 분석을 2006년부터 시행된 6세 미만 아동 입원 정책을 통해 분석하였다. 국민건강보험공단의 표본연구DB를 이용하여 개인의 의료이용 및 건강에 대한 효과를 정책 시행전후와 정책혜택 연령대 여부로 나누어 이중차분모형으로 분석하였다. 분석 결과 입원과 외래 모두 의료이용 일수가 증가하였고, 입원은 의료이용 증가에도 본인부담금이 감소하였다. 입원시 여아보다는 남아가, 고소득층보다는 저소득층에서 본인부담금의 감소가 더 컸다. 재입원으로 본 건강에 대한 결과는 불분명하고, 2008년 본인부담금을 다시 부과하는 정책으로 변경된 후에는 의료이용은 입원만 유의하게 증가하였고, 총요양급여와 본인부담금 모두 증가하였다. 입원에 대한 보험자부담금은 감소하지만 유의하지 않아 2006년 면제 정책에 대한 분석과 차이를 보였다. 본 연구 결과는 향후 건강보험 보장 확대 등의 정책 수립에 활용될 수 있을 것이다.

Abstract

This paper investigates the effect of the Cost Exemption Policy for Hospitalized Children under 6 years old on their medical use and health. We use a difference-in-difference model with controlling for several observable characteristics of children. The estimation results show that the policy increases the medical use, but the policy effect on health is inconclusive. We also find that the policy reform in 2008 increases medical use even though the amount of the subsidy decreases due to the reform. We expect that the results in this paper provide evidence which is useful for designing new policies on the health insurance.

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