위험균등화(Risk Equalization) 도입을 위한 건강보험 위험요인 평가모형 비교 연구 = An Empirical Comparison Research on Health Risk Factor for Effect of Risk Equalization Introduction

다국어 초록 (Multilingual Abstract)

The purpose of this study is for analyzing utilization of each individual insurer at health care insurance market through risk adjustment for expenditure spending risk of the people. This study considered cases of netherlands about Risk Equalization to help understanding of risk equalization introduction. To know what is the closest correlation between variables for estimating expenditure spending risk and healthcare expenditure, this study analyzed data of indemnity private health care insurance. The result of this study presents that risk adjustment leads to competition by consumer`s choice at the healthcare insurance market in spite of using of some variables restrictively. At the same time, this revealed that every utilization of Insurers about risk factors is different in the case of considering reality that insurers feel more delicately than government or central agency operating risk equalization fund in the whole health care insurance system. This study suggest that risk evaluation model introduction could bring every insurer utilization of incentives`s deduction for selection is high and efficient incentives for expenditure saving is low on the competitive health care insurance market. Therefore, this study is valuable that risk evaluation model is analyzed in Korea before enrolling risk equalization policy, and expectable to do an important role of health care reform process.

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