[논문]중·고령 가구의 과부담 의료비 발생의 결정요인에 관한 패널연구

박진영; 정기택; 김용민

doi:10.4332/kjhpa.2014.24.1.56

중·고령 가구의 과부담 의료비 발생의 결정요인에 관한 패널연구
A Panel Study on Determinants of Catastrophic Health Expenditure of the Middle- and Old-Aged Households 원문보기

Health policy and management = 보건행정학회지, v.24 no.1, 2014년, pp.56 - 70

박진영 (경희대학교 대학원 의료경영학과) , 정기택 (경희대학교 대학원 의료경영학과) , 김용민 (경희대학교 대학원 의료경영학과)

Abstract ▼ AI-Helper

Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.

주제어

질의응답

핵심어	질문	논문에서 추출한 답변
	고령화가 급속하게 진행되는 이유는 무엇인가?	우리나라는 저출산과 평균수명의 연장으로 세계에서 유래를 찾아볼 수 없을 정도의 속도로 인구 고령화가 급속하게 진행되고 있다. 이에 따라 지난 2000년에 노인인구 비율이 전체 인구의 7%를 넘어 고령화 사회에 진입하였고, 2017년에는 14%인 고령사회에, 2026년에는 20%를 넘는 초고령사회에 도달할 것으로 예측된다[1].
	고령화 현상의 부정적 효과는 무엇인가?	이에 따라 지난 2000년에 노인인구 비율이 전체 인구의 7%를 넘어 고령화 사회에 진입하였고, 2017년에는 14%인 고령사회에, 2026년에는 20%를 넘는 초고령사회에 도달할 것으로 예측된다[1]. 이러한 고령화 현상은 생산가능인구의 감소로 이어지며, 이로 인한 경제성장 저하는 국가의 경제 및 사회정책의 주요 이슈로 부각되고 있다. 특히 보건의료 측면에서 노인의 평균수명 증가가 개인과 가계, 정부의 추가적인 의료비 부담으로 이어질 수 있다는 점은 주목할 필요가 있다[2].
	가계의 의료비 부담을 해소하기 위한 정부의 보건의료정책은 무엇이 있는가?	이러한 인구 고령화와 만성질환의 증가는 국가 및 가계의 의료비 부담으로 이어질 수 있는데, 정부도 이에 대응하기 위한 보건의료 정책을 수립 · 시행하고 있다. 대표적으로 의료비 부담이 타 질환에 비해 높은 암, 심장질환, 뇌혈관질환, 희귀난치성질환 등 ‘4대 중증 질환 보장강화계획’을 수립하여 세부정책을 시행 중이며, 75세 이상 노인의 부분틀니(2013. 7) 및 임플란트 급여화(2014. 7)가 시행 중이거나 시행될 예정이다. 금년 중에는 만성질환의 예방 · 관리정책을 포함하는 2014-2018 중기 보장성 계획을 마련할 예정이다.

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