민간의료보험 가입자의 보유 보험 특성과 미충족의료 경험의 관련성

Abstract

Private health insurance (PHI) serves as a protective measure against medical expenses resulting from illnesses, aiming to reduce out-of-pocket expenses and enhance accessibility to healthcare utilization. Despite the anticipated benefits for enrollees in terms of reduced possibility of unmet healthcare needs, empirical research on this aspect is limited. Using data from the 2020 Korea Health Panel Survey this study examined the prevalence of unmet healthcare needs among adults aged 20 and above. The analysis considers various demographic factors, including gender, age, education level, marital status, economic activity, National Health Insurance status, income level, health status, medical utilization, and private health insurance enrollment. The logistic regression models are employed to investigate the association between private health insurance enrollment and the possibility of experiencing unmet needs. Results indicated no significant associations between the experiencing unmet healthcare needs and PHI variables such as the presence of PHI, the number of PHI, excessive enrollments, the presence of Fee-for-service (FFS) PHI, and the FFS PHI premium. The only statistically significant variable was the premium amount paid for private health insurance, showing a tendency for individuals who spent more on premiums to have a lower likelihood of experiencing unmet needs. Upon incorporating the dependent variable related to unmet healthcare needs due to economic reasons, the presence, number, and premium amount of PHI showed significant associations, while excessive enrollments and the presence and premium of FFS PHI did not exhibit significant relevance. Contrary to the hypothesis of the study, PHI enrollment did not have a significant impact on reducing unmet healthcare needs, and the likelihood of experiencing such needs due to economic reasons was only partially influenced by PHI. The study suggests a need for reconsideration of the role and utility of PHI, especially when the amount reimbursed in comparison to the premiums paid is limited, and the effectiveness in reducing the psychologically important unmet need experience is constrained. Further exploration is warranted to better understand the nuanced contributions and limitations of PHI in addressing unmet healthcare needs.