[논문]추나요법 건강보험 급여 적용이 자동차보험 한방의료기관의 추나요법료 및 의료이용에 미치는 영향

김경화; 조형경; 이광수

doi:10.4332/kjhpa.2021.31.3.344

Abstract ▼ AI-Helper

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 ...

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 inpatients and 1,550,497 outpatients who received Chuna therapy covered by automobile insurance in oriental medical institutions were included. The analysis period was from July 2018 to December 2019, and a total of 18 months before and after April 2019, when Chuna therapy was covered by national health insurance. Interrupted time series analysis was applied to analyze the impact on the costs and service uses of Chuna therapy in automobile insurance before and after April 2019. Results: From July 2018 to December 2019, for 189,912 inpatients the cost and the number of times for Chuna therapy per capita were increased by 22.0% and decreased by 7.3% respectively right after the implementation of the policy. In the case of 1,550,497 outpatients, the cost of Chuna therapy per capita tends to be increased by 0.4% in overall study periods and increased 28.4% immediately after the implementation of the policy. Meanwhile, the number of times and visits for Chuna therapy per capita tends to be increased by 0.4% in overall study periods but decreased by 0.4% after the implementation of the policy. Conclusion: Results suggest that if the national health insurance coverage of oriental medicine services increases according to the policy stance for benefit expansion in national health insurance, the criteria for providing national health insurance benefits should be considered with the comprehensive impacts on the costs and service uses of automobile insurance.

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표/그림 (7)

그림 Figure 1. Research model.
표 Table 1. General characteristics of inpatients and outpatients treated Chuna therapy in automobile insurance oriental medical institutions during study periods
표 Table 2. General characteristics of the cost and service uses of Chuna therapy in automobile insurance oriental medical institutions during study periods
표 Table 3. Results of interrupted time series analysis in costs and service uses of Chuna therapy for inpatients in automobile insurance oriental medical institutions
표 Table 4. Results of interrupted time series analysis in costs and service uses of Chuna therapy for outpatients in automobile insurance oriental medical institutions
그림 Figure 2. Changes in the cost and use of Chuna therapy for inpatients in automobile insurance oriental medical institutions before and after the implementation of policy on Chuna therapy covered by National Health Insurance. (A) Cost of Chuna therapy per capita. (B) Number of times for Chuna therapy per capita. (C) Length of stays for Chuna therapy per capita.
그림 Figure 3. Changes in the cost and use of Chuna therapy for outpatients in automobile insurance oriental medical institutions before and after the implementation of policy on Chuna therapy covered by National Health Insurance. (A) Cost of Chuna therapy per capita. (B) Number of times for Chuna therapy per capita. (C) Number of visits for Chuna therapy per capita.

참고문헌 (15)

National Health Insurance Service. 2019 Survey on medical expenses of national health insurance patients. Wonju: National Health Insurance Servic; 2020.
Hwang DK, Lim BM, Shin YS, Lee SY, Kim HS, Shin BC, et al. Evaluation study of pilot project for national health insurance coverage of Chuna therapy. Wonju: Health Insurance Review & Assessment, Korea Institute for Health and Social Affairs; 2018.
Ministry of Health and Welfare. Chuna therapy applies as benefits of national health insurance and for medical aid. Sejong: Ministry of Health and Welfare; 2019.
Health Insurance Review and Assessment. Criteria, guidelines for providing reimbursed services in the automobile insurance. Wonju: Health Insurance Review and Assessment; 2021.
Ministry of Land, Infrastructure and Transport. Criteria for providing Chuna therapy in automobile insurance is in place to ensure the patient's rights. Sejong: Ministry of Land, Infrastructure and Transport; 2019.
Kim HB. Under National Health Insurance coverage of Chuna therapy, the insurance companies will raise auto insurance premiums. Seoul Economy News [Internet]. 2019 Mar 12 [cited 2021 Jul 14]. Available from: http://www.seouleconews.com/news/articleView.html?idxno48879.
Chae JM, Lee CS, Shin K. A study of the effect on the public and private insurances caused by national health insurance coverage of Chuna treatment. Korean J Insur 2019;118(4);105-138. DOI: https://doi.org/10.17342/KIJ.2019.118.4.

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상세보기
Song YA. The effects of National Health Insurance coverage of Chuna therapy on automobile insurance. KIRI Rep 2019;(465):1-9.
Ministry of Health and Welfare; Yonsei University; Korea Institute for Health and Social Affairs; National Health Insurance Service; Health Insurance Review and Assessment. Korean National Health Accounts in 2018. Sejong: Ministry of Health and Welfare; 2020.
Health Insurance Review and Assessment. 2019 Automobile insurance statistical yearbook. Wonju: Health Insurance Review and Assessment; 2020.
Ministry of Health and Welfare; Health Insurance Review and Assessment. Guidelines for Chuna therapy pilot project. Sejong: Ministry of Health and Welfare; 2017.

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