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노인장기요양보험 인정자의 미이용 관련요인 분석: 전남지역을 대상으로
국경남 ( Kyung Nam Kuk ),김노을 ( Ro Eul Kim ),임승지 ( Seung Ji Lim ),박종연 ( Chong Yon Park ),김재윤 ( Jae Yeun Kim ),정우진 ( Woo Jin Chung ) 한국보건행정학회 2014 보건행정학회지 Vol.24 No.4
Background: This study aimed to explore factors associated with the non-use of beneficiaries of long-term care insurance services for the elderly in Jeollanam-do Province by analyzing a dataset obtained from National Health Insurance Service. Methods: The study sample consists of 1,663 individuals who were evaluated as eligible for long-term care insurance services in Je-ollanam-do Province during the period of July 1, 2008 through June 30, 2009. As a dependent variable, the non-use of the service was defined as one when a beneficiary had used it once or more times during one year after he or she was evaluated as eligible and as zero otherwise. A proportion analysis was conducted to describe characteristics of study sample. Chi-square tests were used to compare general characteristics between beneficiaries who had used the services and those who had not used them. Multiple lo-gistic regressions were performed by three models including additional sets of explanatory variables such as socio-demographic characteristics, health conditions, and economic status. Results: Main results are summarized as follows. The proportion of beneficiaries who had not used the service was 14.5% of all ben-eficiaries. According to the results from the model using all explanatory variables, the factors associated with the non-use of the ser-vices were residence location, dwelling place, type of desired service, level of care needs, and instrumental activities of daily life limi-tations. Conclusion: In particular, regarding the type of desired service, the cash benefit showed a high likelihood of the non-use of the ser-vice; it had an odds ratio (OR) of 50.212 (95% confidence interval [CI], 24.00-105.04) compared with home service. In case of dwelling place, a hospital showed also a high likelihood of the non-use with an OR of 20.71 (95% CI, 10.12-42.44) compared with home.
한남경 ( Nam Kyung Han ),정우진 ( Woo Jin Chung ),김노을 ( Ro Eul Kim ),임승지 ( Seung Ji Lim ),박종연 ( Chong Yon Park ) 한국보건행정학회 2013 보건행정학회지 Vol.23 No.2
Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91 .63% and the drug expenses have increased by 3 1 .85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.60/0. And outpatient expenses have increased by 10.40/0, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.