[논문]공공 및 민영의료보험의 비급여 관리정책에 대한 국가별 비교

김하윤; 장종원

doi:10.4332/kjhpa.2022.32.2.137

공공 및 민영의료보험의 비급여 관리정책에 대한 국가별 비교
International Comparison of the Non-benefits Management Policies for Public and Private Health Insurance 원문보기

Health policy and management = 보건행정학회지, v.32 no.2, 2022년, pp.137 - 153

김하윤 (국민건강보험공단 비급여관리실) , 장종원 (국민건강보험공단 비급여관리실)

Abstract ▼ AI-Helper

In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as 'large or small,' and the government's regulation and management policy on private health insurance was classified as 'strong or weak.' Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government's management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries' cases.

주제어

표/그림 (4)

그림 Figure 1. Research structure and contents.
그림 Figure 2. Comparison of non-benefits areas. (A) Benefit areas covered by public health insurance (include copayment); (B) non-benefit areas covered by private health insurance; and (C) Non-benefit areas not covered by private health insurance.
표 Table 1. Comparison of interaction, authority and responsibility between public and private health insurance
그림 Figure 3. Current situation and future direction for comparison interaction, authority and responsibility between public and private health insurance. (A) Current situation of interaction, authority and responsibility between public and private health insurance. (B) Future direction of interaction, authority and responsibility through linkage and cooperation between public and private health insurance.

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공공 및 민영의료보험의 비급여 관리정책에 대한 국가별 비교
International Comparison of the Non-benefits Management Policies for Public and Private Health Insurance 원문보기

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공공 및 민영의료보험의 비급여 관리정책에 대한 국가별 비교 International Comparison of the Non-benefits Management Policies for Public and Private Health Insurance 원문보기

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공공 및 민영의료보험의 비급여 관리정책에 대한 국가별 비교
International Comparison of the Non-benefits Management Policies for Public and Private Health Insurance 원문보기

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