건강보험 노인의료비의 효율적 관리방안

제목
건강보험 노인의료비의 효율적 관리방안
Efficient Management of Health Insurance Expenditures on the Elderly
저자

신현웅; 윤장호; 이슬기; 하솔잎

키워드
노인의료; 진료비증가; 증가요인; 효율화방안
발행연도
2012
발행기관
한국보건사회연구원
초록
This study attempts to analyze factors responsible for the increasing elderly health expenditures and the health care use of the elderly. The goal is to suggest efficient ways of managing expenditure on health services for the elderly.
The increase in the elderly expenditure is found to have been due to the increase in the number of service recipients, the increase in days of visit, and the increase in fee per visit, which accounts respectively for 26.5~35.8%, 22.1~60.5% and 5.1~46.1%, depending on the type of service. The increase in days of visit is found to have contributed 60.5% of the increase in elderly inpatient expenditure. Pharmaceutical expenditure took the biggest share of 46.1% in the increase in fee per visit.
The ways this study suggests of managing elderly health expenditure are for providers, users, and the National Health Insurance. From the perspective of health care provision, this study recommends strengthened management for providers who deliver services more than medically necessary, establishment of an elderly health care cost information system, and improved quality of service provision. For the elderly population, the study suggests to step up efforts to promote healthy lifestyle behavior, educate the elderly about rational use of health services, and provide a rational level of support for elderly in their use of health services. Also, at the institutional level, improvements need to be made in the system of the National Health Insurance, in terms of reimbursement rules, age criteria, copayment rules, the supply of long-term care beds, and the role of the long-term care insurance.
목차
요약 3

제1장 서론 21
제1절 연구의 필요성 21
제2절 연구목적 22

제2장 선행연구 27
제1절 공급자 측면 증가요인 27
제2절 수요자 측면 증가요인 33

제3장 노인의료이용 실태분석 49
제1절 전통적인 진료비 분해 49

제4장 노인의료이용에 영향을 주는 요인 85
제1절 분석자료 85
제2절 방법론 91
제3절 분석 결과 95
제4절 결론 105

제5장 노인의료비의 효율적 운영방안 109
제1절 노인의 만성질환 관리를 위한 사전적 예방 110
제2절 의료전달체계의 강화 113
제3절 단골의사제도와 연계한 본인부담제도 개선 118
제4절 의료공급자 측면의 관리방안 121

참고문헌 129

부록 141
보고서 번호
연구보고서 2012-17
ISBN
978-89-8187-945-7
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