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김용민 ( Kim Yongmin ),정기택 ( Jung Keetaig ),박진영 ( Park Jinyoung ) 한국사회보장학회 2016 사회보장연구 Vol.32 No.3
본 연구는 한국복지패널 2010~2013년도 조사에 모두 응답한 5,002개 가구를 대상으로 과부담 의료비의 발생과 재발생의 현황 및 영향요인에 관해 분석을 하였으며, 특히 과부담 의료비 재발생의 통계적 유의성을 상태 의존성이라는 개념을 적용하여 검증하고자 하였다. 본 연구의 주요 분석 결과는 다음과 같다. 첫째, 과부담 의료비의 일시적 발생과 재발생에 영향을 미치는 요인은 다르게 나타났다. 둘째, 과거 과부담 의료비가 발생했던 가구는 미래에도 과부담 의료비가 발생할 확률이 높게 나타났다. 즉, 과부담 의료비 발생에 상태 의존성이 존재하는 것으로 나타났다. 셋째, 민간의료보험 가입 가구가 비가입 가구에 비해 과부담 의료비 발생뿐만 아니라 재발생 확률도 낮게 나타났다. 넷째, 3대 중증질환은 과부담 의료비의 발생 및 재발생 위험을 증가시키는 것으로 나타났으나 당뇨병, 신장질환 등 非 3대 중증질환도 과부담 의료비 발생 및 재발생 위험을 증가시키는 것으로 나타났다. 본 연구에서 확인한 과부담 의료비 발생 및 재발생 영향요인들은 향후 국민건강보험의 보장성 강화 및 국민들의 건강 향상을 위한 정책 수립에 시사점을 줄 수 있다 하겠다. This research analyzed 5,002 households which responded to Korea Welfare Panel Study conducted from 2010 to 2013 and conducted in-depth analysis related to CHE. Catastrophic Health Expenditure(CHE) is defined if a household`s health expenditure against ability to pay is equal or greater than threshold and the threshold in this research is 20%. This research analyzed the factors influencing CHE recurrence as well as occurrence and expecially verified the statistical significance of CHE recurrence applying the concept of state dependence. The major results of this research are as follows. First, the influence factors of CHE occurrence and recurrence are different. Second, households which had experienced CHE showed high possibility of future CHE occurrence. In other words, state dependence in CHE exists. And the level of healthcare expenditure against ability to pay of households which experienced CHE recurrence showed high level of healthcare expenditure against ability to pay in future. Third, households which had insured by private health insurance showed low possibilities of CHE occurrence and recurrence. Fourth, the three severe diseases increased the possibilities of CHE occurrence and recurrence, but the diseases not included in the three severe diseases such as diabetes and kidney ailments also increased the possibilities of CHE occurrence and recurrence.
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병원의 서비스 회복이 공정성 지각과 행동의도에 미치는 영향
전진우 ( Jinwoo Jeon ),백미라 ( Mira Baek ),정기택 ( Keetaig Jung ),이훈영 ( Hoonyoung Lee ) 경희대학교 경영연구원 2015 의료경영학연구 Vol.9 No.3
This research analyzed correspondence effort what the hospital cope with, relation of fairness sensation, fairness and customer satisfaction which is perceived by service recovery, perceived value, hospital image and influencing relationship of future behavior intention to recover service failure. In result of the research, refund and discount among the hospital correspondence effort have a most effect on distribution fairness. This means customers show most positive response about typical output of service recovery strategy. Also, we can know importance of policy, process, tools to support customer`s complain and hospital swift response. Apologize and explanation influences to mutual relation fairness perception positively. Here is intriguing result. procedural justice in contrary with distributive justice and interactional justice doesn```t have a positive affect to perceived value. In other words, typical reward and heartfelt apologize and explanation has positive affect to perceived value, perceived value of policy, process, tools used by decision maker doesn``t have positive affect to customer`s perceived value. On the other hand, customer`s perceived value and satisfaction about perceived justice through service recovery has a positive affect to hospital image, this hospital image has positive affect to future behavior intention. There were multiple researches that can be used for all sorts of things. But, the research for hospital was insufficient. What is important is that we draw an objective research conclusion considering that hospital is one of the service company. Also, in case of medical service failure, it can be used for reference about service recovery method that customers want, and it can be helpful to improvement of medical service quality.
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