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    보장성 강화정책이 만성질환자 및 중증질환자 보유가구의 과부담 의료비 발생에 미친 영향 = Effects of the benefit extension policy on the burdening of health care expenditure for households with patients of chronic or serious case

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    https://www.riss.kr/link?id=A104443106

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    부가정보

    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket share of patients of serious case and expanding the medical bill ceiling system to mention just a few. This study proposes to confirm effectiveness of the benefit extension policy by identifying changes in‘out-of-pocket expenditure as a share of the ability to pay’and‘incidence rate of catastrophic health care expenditure’of each individual household as manifested before and after the benefit extension policy was implemented. The 1st and 3rd year data from the Korea Welfare Panel Study (KoWePS), conducted by the Korea Institute for Health and Social Affairs (KIHASA), were used for the analysis, where low-income households and ordinary households are sampled separately.
    While the absolute amount of‘out-of-pocket expenditure’occurred to the average household increased for the period 2005-2007, the‘out-of-pocket expenditure as a share of the ability to pay’decreased. At the same time, the share decreased in the case of low-income households and households with patients of chronic or serious case as contrasted with ordinary households. ‘Incidence rates of catastrophic health care expenditure’of ordinary households for 2007 stood at 14.6%, 5.9% and 2.8% at the threshold of 10%, 20% and 30%, respectively. The rates decreased overall between 2005 and 2007, while those of low-income households with patients of serious case statistically significantly increased. An analysis of this study indicates that it is related with the medical bill ceiling system regardless of incomes introduced in 2007.
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    Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket sh...

    Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket share of patients of serious case and expanding the medical bill ceiling system to mention just a few. This study proposes to confirm effectiveness of the benefit extension policy by identifying changes in‘out-of-pocket expenditure as a share of the ability to pay’and‘incidence rate of catastrophic health care expenditure’of each individual household as manifested before and after the benefit extension policy was implemented. The 1st and 3rd year data from the Korea Welfare Panel Study (KoWePS), conducted by the Korea Institute for Health and Social Affairs (KIHASA), were used for the analysis, where low-income households and ordinary households are sampled separately.
    While the absolute amount of‘out-of-pocket expenditure’occurred to the average household increased for the period 2005-2007, the‘out-of-pocket expenditure as a share of the ability to pay’decreased. At the same time, the share decreased in the case of low-income households and households with patients of chronic or serious case as contrasted with ordinary households. ‘Incidence rates of catastrophic health care expenditure’of ordinary households for 2007 stood at 14.6%, 5.9% and 2.8% at the threshold of 10%, 20% and 30%, respectively. The rates decreased overall between 2005 and 2007, while those of low-income households with patients of serious case statistically significantly increased. An analysis of this study indicates that it is related with the medical bill ceiling system regardless of incomes introduced in 2007.

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    참고문헌 (Reference)

    1 손수인, "저소득층의 과부담의료비 발생에 영향을 미치는 요인" 한국보건사회연구원 30 (30): 92-110, 2010

    2 이수연, "의료서비스 이용 및 치료비 부담률의 비형평 원인에 관한 연구" 10 (10): 415-447, 1997

    3 지은정, "의료비 지출이 종사상 지위 및 소득변화에 미치는 요인요구" 한국사회복지학회 56 (56): 5-35, 2004

    4 허순임, "우리나라 건강보험 보장성 개선 정책에 대한 평가" 한국보건행정학회 19 (19): 142-165, 2009

    5 국민건강보험공단, "소득수준별 본인부담상한제 차등 적용 방안" 국민건강보험공단 2008

    6 김태일, "소득 계층별 의료비 부담의 추이와 정책 과제" 한국보건행정학회 18 (18): 23-48, 2008

    7 한국보건사회연구원, "서울대학교 사회복지연구소. 1, 3차년도 한국복지패널 조사자료사용자 지침서" 보건사회연구원 2008

    8 김학주, "빈곤층의 의료비지출 과부담에 관한 연구" 9 (9): 229-254, 2008

    9 이용재, "본인부담경감이 암 환자의 건강보험이용에 미친 영향" 한국재정정책학회 11 (11): 3-25, 2009

    10 이태진, "보건의료 비용 지출의 형평성" 9 (9): 25-34, 2003

    1 손수인, "저소득층의 과부담의료비 발생에 영향을 미치는 요인" 한국보건사회연구원 30 (30): 92-110, 2010

    2 이수연, "의료서비스 이용 및 치료비 부담률의 비형평 원인에 관한 연구" 10 (10): 415-447, 1997

    3 지은정, "의료비 지출이 종사상 지위 및 소득변화에 미치는 요인요구" 한국사회복지학회 56 (56): 5-35, 2004

    4 허순임, "우리나라 건강보험 보장성 개선 정책에 대한 평가" 한국보건행정학회 19 (19): 142-165, 2009

    5 국민건강보험공단, "소득수준별 본인부담상한제 차등 적용 방안" 국민건강보험공단 2008

    6 김태일, "소득 계층별 의료비 부담의 추이와 정책 과제" 한국보건행정학회 18 (18): 23-48, 2008

    7 한국보건사회연구원, "서울대학교 사회복지연구소. 1, 3차년도 한국복지패널 조사자료사용자 지침서" 보건사회연구원 2008

    8 김학주, "빈곤층의 의료비지출 과부담에 관한 연구" 9 (9): 229-254, 2008

    9 이용재, "본인부담경감이 암 환자의 건강보험이용에 미친 영향" 한국재정정책학회 11 (11): 3-25, 2009

    10 이태진, "보건의료 비용 지출의 형평성" 9 (9): 25-34, 2003

    11 이원영, "도시가계의 소득계층별 과부담의료비 실태" 한국사회보장학회 21 (21): 105-132, 2005

    12 이원영, "도시가계 의료비 지출의 형평성" 한국보건행정학회 15 (15): 30-56, 2005

    13 김학주, "계층간 진료비 본인부담의 형평성에 관한 연구" 한국사회복지학회 56 (56): 113-133, 2004

    14 정형선, "건강보험 보장성 지표 개발연구" 국민건강보험공단 2010

    15 국민건강보험공단, "건강보험 보장성 정책 평가 및 확대 대상 검토" 국민건강보험공단 2009

    16 윤희숙, "건강보험 보장성 강화 정책의 방향과 의사결정방식의 문제점" 5 (5): 81-86, 2007

    17 Feenberg, D., "The Risk and Duration of Catastrophic Health CareExpenditures" 76 (76): 633-647, 1994

    18 Xu K, "Protecting Households From Catastrophic Health Spending" 26 (26): 972-983, 2007

    19 Kawabata, K, "Preventing impoverished through protectionagainst catastrophic health expenditure. WHO" 80 (80): 612-, 2002

    20 Somkotra T, "Payments for health care and its effect oncatastrophe and impoverishment: experience from the transition toUniversal Coverage in Thailand" 67 (67): 2027-2035, 2008

    21 Gross DJ, "Out-ofpocket health spending by poor and near-poor elderly Medicarebeneficiaries" 34 (34): 241-254, 1999

    22 Ziller EC, "Out-of-pocket health spending and therural underinsured" 25 (25): 1688-1699, 2006

    23 OECD, "OECD Health Data"

    24 Chu, T. B, "Householdout-ofpocket medical expenditures and National health Insurance inTaiwan: income and regional inequality" 5 (5): 2005

    25 Xu K, "Householdcatastrophic health expenditure: a multicountry analysis" 362 (362): 111-117, 2003

    26 Goldman DP, "High out-of-pocket health care spending bythe elderly" 22 (22): 194-202, 2003

    27 Feldstein, PJ, "Health Care Economics: 6th Edition" Delmar Learning 2004

    28 Wyszewianski, "Families with Catastrophic Health Care Expenditure" 21 (21): 617-, 1986

    29 Knaul FM, "Evidence is good for your health system: policyreform to remedy catastrophic and impoverishing health spending inMexico" 368 (368): 1828-1841, 2006

    30 Xu K, "Distribution of Health Payments and Catastrophic ExpendituresMethodology" WHO 2005

    31 van Doorslaer E, "Catastrophic payments for health care in Asia" 16 (16): 1159-1184, 2007

    32 Su, T. T, "Catastrophic household expenditure forhealth care in a low-income society: a study from Nouna District, BurkinaFaso" 84 : 21-27, 2006

    33 Limwattananon S, "Catastrophic andpoverty impacts of health payments: results from national householdsurveys in Thailand" 85 (85): 600-606, 2007

    34 Wagstaff A, "Catastrophe and impoverishment in paying forhealth care: with applications to Vietnam 1993–1998" 12 (12): 921-934, 2003

    35 Berki SE, "A look at catastrophic medical expenses and the poor" 5 (5): 138-145, 1986

    36 보건복지부 중앙생활보장위원회, "2010 최저생계비 보도자료"

    37 보건복지부, "2005 건강보험 보장성 강화방안" 보건복지부 2005

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    연월일 이력구분 이력상세 등재구분
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    2021-01-01 등재 등재학술지 유지 (재인증) KCI등재
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    2013-03-11 학회명변경 영문명 : The Korean Society Of Health Policy And Administration -> Korean Academy of Health Policy and Management KCI등재
    2013-03-11 학술지명변경 외국어명 : Korean Journal of Health Policy and Administration -> Health Policy and Mangemnet KCI등재
    2011-01-01 등재 등재학술지 유지 (등재유지) KCI등재
    2009-01-01 등재 등재학술지 유지 (등재유지) KCI등재
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    2002-01-01 등재 등재후보학술지 유지 (등재후보1차) KCI등재후보
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    기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
    2016 0.78 0.78 0.8
    KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
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