의료보장 유형에 따른 의료 접근성 연구: 과부담 의료비 지출과 미충족 의료 경험을 중심으로

초록

The purpose of this study is to analyze the scale of occurrence and factors influencing the household Catastrophic Health Expenditure(CHE) and unmet needs based on the types of health care system, such as employee insured and self-employed insured in National Health Insurance(NHI), and Class 1 and 2 recipients in Medical Aid Program. For the empirical analysis, logistic regression analysis was employed using the data of 5th wave in Korea Welfare Panel(KOWEP). The occurrence of the CHE in the entire households appeared to be 21.1%, 22.1%, 24.9%, and 12.5% with the threshold at 10%, 20%, 30%, and 40%, respectively. The main factors that determined the CHE were the number of household members, the gender and health conditions of householder, the existence of either old aged or chronic disease patients, low-income households, and types of health care system, etc. It also showed that employee insured in NHI rated higher probability to have the CHE than those with self-employed insured or the recipients in Medical Aid Programs. Only about 1.4% of households experienced unmet health needs. The factors influencing those unmet needs were the educational level and health condition of households, the existence of either old aged or chronic disease patients, low income households, and types of health care system. It was also reveled that the probability of unmet needs for self-employed insurer was higher than that for employee insurer in NHI. These findings suggest that co-payment system in Medical Aid Program must be modified or eliminated in order to improve the equity of health accessibility among poor and near poor in Korea.

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