The Effect of Non-Payment, Optional Treatment, and Hospitalization Decision on the Payment of Medical Expenses
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The purpose of this study is to provide the basic data for related policies by analyzing the relationship between the non-payment, optional treatment, hospitalization decision, and the payment of medical expenses. A total of 7,317 inpatients were selected as the final subjects using the 2011-2015 data of the Korea Medical Panel. It was analyzed using the chi-square test and the generalized estimating equation (GEE), and the demographic variables affecting payment of medical expenses and use of medical treatment variables were included as the correction variables. As a result of the analysis performed, compared to the inpatients with non-payment expenditures less than 250,000 won, 250,000 won to 500,000 won (OR: 1.19 95% CI: 1.01-1.39, P-value: 0.0319), 500,000 won to less than 1 million won (OR: 1.75 95% CI: 1.46-2.09, P-value: <.0001), over 1 million won (OR: 1.58 95% CI: 1.27-1.96, P-value: <.0001), there was a burden on the expenditure of medical expenses. Furthermore, while there was no recommendation for optional treatment, the inpatients who received optional treatment had a higher payment of medical expenses compared to the inpatients who did not (OR: 1.20 95% CI: 1.00-1.45, P-value: 0.0490). The patients who decided to be hospitalized had a higher payment of medical expenses than those who decided to be hospitalized by themselves (OR: 1.14 95% CI: 1.03-1.27, P-value: 0.0149). As a result of this study, the non-payment, optional treatment, and the hospitalization decision had an effect on the payment of medical expenses. Optional treatment was closed after 2018, but the payment of medical expenses due to the non-payment and the hospitalization decisions still exists, and hence, there is a need for the policy improvement to reduce them.
Abstract
The purpose of this study is to provide the basic data for related policies by analyzing the relationship between the non-payment, optional treatment, hospitalization decision, and the payment of medical expenses. A total of 7,317 inpatients were selected as the final subjects using the 2011-2015 data of the Korea Medical Panel. It was analyzed using the chi-square test and the generalized estimating equation (GEE), and the demographic variables affecting payment of medical expenses and use of medical treatment variables were included as the correction variables. As a result of the analysis performed, compared to the inpatients with non-payment expenditures less than 250,000 won, 250,000 won to 500,000 won (OR: 1.19 95% CI: 1.01-1.39, P-value: 0.0319), 500,000 won to less than 1 million won (OR: 1.75 95% CI: 1.46-2.09, P-value: <.0001), over 1 million won (OR: 1.58 95% CI: 1.27-1.96, P-value: <.0001), there was a burden on the expenditure of medical expenses. Furthermore, while there was no recommendation for optional treatment, the inpatients who received optional treatment had a higher payment of medical expenses compared to the inpatients who did not (OR: 1.20 95% CI: 1.00-1.45, P-value: 0.0490). The patients who decided to be hospitalized had a higher payment of medical expenses than those who decided to be hospitalized by themselves (OR: 1.14 95% CI: 1.03-1.27, P-value: 0.0149). As a result of this study, the non-payment, optional treatment, and the hospitalization decision had an effect on the payment of medical expenses. Optional treatment was closed after 2018, but the payment of medical expenses due to the non-payment and the hospitalization decisions still exists, and hence, there is a need for the policy improvement to reduce them.
참고문헌 (27)
- 안병기, "환자 및 가족에 의한 입원이용 결정의 양상", 보건경제와 정책연구, 23(3), pp.87~105 (2017), 한국보건경제정책학회
- 안영진, "향후 5년, 진료실 온도를 바꿀 보험 키워드 세 가지", 임상이비인후과, 30(2), pp.303~311 (2019), 대한이비인후과학회 부산,울산,경남 지부회[DOI]
- 안병기, "입원환자 본인부담액에 영향을 미치는 요인", 보건행정학회지, 22(3), pp.451~465 (2012), 한국보건행정학회
- 안병기, "종합전문요양기관과 종합병원의 선택진료 결정요인", 보건행정학회지, 21(4), pp.599~616 (2011), 한국보건행정학회
- 조홍준, "보건의료에서의 형평성: 우리나라의 현황", 대한의사협회지, 56(3), pp.184~194 (2013), 대한의사협회
- 최다혜, "치과보철치료의 기능적 만족도와 심리⋅심미적 만족도에 영향을 미치는 요인", 한국치위생학회지, 15(2), pp.225~233 (2015), 한국치위생학회[DOI]
- Health Insurance Patients' Medical Expenses Survey in 2018, "Choi, S.", National Health Insurance Corporation Health Insurance Policy Research Institute, 9~21 (2018)
- 최영순, "건강보험 입원환자의 주관적 의료비 부담에 영향을 미치는 요인", 간호행정학회지, 17(2), pp.147~157 (2011), 간호행정학회
- Do, Y., "Difference of the medical cost of the individual families" (2007), Korea Labor Institute
- Hayashi, Y., "Economic theoretical consideration on mixed medical care system", Med Care Soc, 13(3), pp.73~85 (2003)[DOI]
- Kim, C. Y., "Theories of Health Security" (2009), Hanul Academy
- 김학주, "의료비지출 과부담이 빈곤에 미치는 영향에 관한 연구: 고정효과 패널분석을 중심으로", 생명연구, 49, pp.473~524 (2018), 생명문화연구소[DOI]
- Kim, H. -H., "Implications of Recent Trends Related to Uncovered Medical Services Costs", HIRA Research, 10(6), pp.7~19 (2016)
- Kim, J. H., "Advance beneficiary notice of non-coverage", 14(6), pp.47~55 (2020)
- 김교성, "의료보장 유형에 따른 의료 접근성 연구: 과부담 의료비 지출과 미충족 의료 경험을 중심으로", 사회복지정책, 39(4), pp.255~279 (2012), 한국사회복지정책학회[DOI]
- Kong, I. S., "Policy on non-covered health services", HIRA Research, 14(6), pp.7~22 (2020)
- Kong, J. S., "Policies on the Management of Uncovered Services to Reduce Medical Expenses in the NHI", Health and Welfare Forum, 2017(6), pp.18~29 (2017)
- 이혁수, "과부담의료비와 미충족의료 경험에 관한 연구: 민간의료보험을 반영한과부담의료비 산식의 적용", 비판사회정책, (55), pp.7~38 (2017), 비판과 대안을 위한 사회복지학회[DOI]
- 이혜재, "미충족의료와 비급여진료비가 과부담의료비 발생에 미치는 영향", 보건경제와 정책연구, 21(3), pp.55~79 (2015), 한국보건경제정책학회
- 나비, "선택진료 및 상급병실제도 개선정책이 건강보험 보장성에 미친 영향: 일개 상급종합병원 입원 진료비를 중심으로", 병원경영학회지, 23(1), pp.51~64 (2018), 한국병원경영학회
- 오은환, "의료서비스 선택과 비급여 의료비 부담: 일본 혼합진료금지제도 고찰", 보건행정학회지, 31(1), pp.17~23 (2021), 한국보건행정학회
- Seo, I. S., "The medical Community Admittance Related to Uncovered Medical Services Costs Publication", HIRA Research, 10(6), pp.20~26 (2016)
- 신혜리, "과부담 의료비 지출이 미충족 의료경험에 미치는 영향 - 민간의료보험 가입의 조절효과를 중심으로 -", 지역사회연구, 22(3), pp.25~48 (2014), 한국지역사회학회[DOI]
- 신세라, "중고령자 가계의 사망 전 본인부담 의료비 지출에 관한 연구", Financial Planning Review, 11(3), pp.79~104 (2018), 한국FP학회
- Shin, Y. J., "Recent trends and Implications of US Medicare Advanced Beneficiary Notice of Noncoverage(ABN)", HIRA Research, 15(1), pp.77~86 (2021)
- 신영전, "미 충족의료의 현황과 관련요인 -1차, 2차 한국복지패널자료를 이용하여-", 보건사회연구, 29(1), pp.95~122 (2009), 한국보건사회연구원[DOI]
- Yeo, N., "Policy on non-reimbursable services in the National Health Insurance", Health and Welfare Forum, 403, pp.23~37 (2020)