요양보호사 임금결정요인 분석

나영균 ( Young-kyoon Na ),정형선 ( Hyoung-sun Jeong ) 한국보건행정학회 2019 보건행정학회지 Vol.29 No.4

Background: In this study, wage status and wage determinants of care workers were analyzed. Methods: The analysis used database (DB) of long-term care institutions, DB of long-term care institutions, DB of long-term care workers, DB of health insurance qualification, and contribution possessed by National Health Insurance Services. We analyzed the wage status of the care workers from 2009 to 2016 through basic analysis and estimated the factors affecting the wage of the long-term care facilities’ care workers using pooled ordinary least squares. Results: The monthly average wage of care workers was raised from Korean won (KRW) 1.37 million in 2009 to KRW 1.52 million in 2016, and the working hours were shortened by 20 hours from 207 hours to 187 hours. Hourly wages increased by KRW 1,329 from KRW 6,831 in 2009 to KRW 8,160 in 2016. The average monthly wage of care workers was affected by gender, age, years of employment, monthly working hours, establishment type, city size, institutional size, the grade of the institution, and management status. In particular, the wage level of the care workers was high when the larger the size of the institution, the better the management status (fill rate), the establishment type is “government and local government” and “corporation,” the institutional rating is high, and the facility manager has the first grade of the social worker license. Conclusion: The government should consider aggressive policies to improve the treatment of care workers as well as the quality of long-term care services so that there will be more long-term care facilities that are guaranteed social publicity above a certain level.

건강보험 지역가입자의 보험료 역진성 분석

나영균 ( Young-kyoon Na ),문용필 ( Yongpil Moon ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.3

Background: This study aims to examine the regressiveness of national health insurance (NHI) premium burdens for local subscribers. The government has established a restructuring of health insurance contributions in 2017. Therefore, insurance premium reform began in 2018 and the second national health insurance premium reform will be carried out in 2022. We will analyze local subscribers before and after the policy reform of 2018. Methods: This study used data from ‘local premium imposition elements’ in the health insurance statistics annual reports (2017-2019) on National Health Insurance Service (NHIS). This study was calculated contribution rates according to levels of income and property for local insured by the method of comparing. Simulations of primary and secondary reforms were conducted in the study to determine regressiveness. Results: Insurance premiums for local subscribers were analyzed separately by income and property insurance premiums. In the income premium analysis, the higher the income, the lower the premium rate, and then the fixed rate was maintained from a certain section. The regressiveness of income insurance premiums has been eased in part. On the other hand, the property insurance premium burden was found to be regressive still by income class. Conclusion: Regressiveness analysis showed that a decrease in income contributions was achieved to local insured in the first phase of reform. But in the second phase of reform, more consideration should be given to reductions of property premium portions of local subscribers. Based on the results, the author suggested policy discussions to reorganizing the new systems of NHI contribution of local Insured.

건강보험가입자의 의료급여 자격변동에 따른 의료이용행태 변화 연구

나영균 ( Young-kyoon Na ),차예린 ( Yerin Cha ),김나영 ( Nayoung Kim ),이영재 ( Youngjae Lee ),이용갑 ( Yong-gab Lee ),임승지 ( Seungji Lim ) 한국보건행정학회 2020 보건행정학회지 Vol.30 No.4

Background: The purpose of this study is to analyze whether there is a change in patterns of medical use among those likely to be converted their health insurance qualifications when the family support rule is alleviated. There is no empirical analysis that converting health insurance qualification will affect the increase in medical use. Methods: For analysis, data were extracted from the national health insurance eligibility and medical care database. To identify analysis targets similar to that of medical aids’ characteristics among health insurance coverage, we compared income, property level, and medical use patterns through basic statistical analysis and used a difference-in-difference (DID) analysis to estimate the net effect of changes in medical use following the change of qualifications. Results: The main results are as follows. The results show that those who are under the 5% income group (1st income group) of health insurance coverage are the most similar to the medical aids group. DID analysis shows that changes in the medical use of people who maintain their national insurance qualification and who are not. As a results, the number of hospitalized days of converting group was reduced by 3.5 days while outpatient days were increased by 1.8 days. Conclusion: As a result, there was not much difference in the patterns of medical use for the under 5% income group who are likely to be eligible for expanded medical aids when the family support rule is alleviated. In addition, more than 30% of them are in arrears with their health insurance premiums, causing inconvenience in using medical services. These findings suggest the need of abolishing the criteria obligated to support family, and great efforts should be made to contribute to non-paid poor and remove their medical blind spot.

요양보호사 처우개선비 정책이 임금인상에 미친 효과

나영균 ( Young-kyoon Na ),정형선 ( Hyoung-sun Jeong ) 한국보건행정학회 2020 보건행정학회지 Vol.30 No.1

Background: The purpose of this study is to analyze the effect of the income support allowance policy for the care workers on wage level. Methods: The analysis data was constructed using database (DB) of long-term care institution, DB of long-term care personnel status, and DB of health insurance qualification and contribution possessed by National Health Insurance Services. We analyzed the wage status of care workers 2009 to 2016 through basic analysis. We used the difference-in-difference analysis method for the workers who worked in the same institution from 2012 to 2013, The effects of the income allowance policy on wage increase were analyzed. Results: As a result of the net effect of the income support allowance policy, the monthly average wage of the care worker increased by 25,676 won and the hourly wage increased by 478 won. As a result of the analysis, it can be confirmed that the income support allowance policy has achieved some of the goals of raising the wage level of the care workers, and the effect of raising wages for other occupations in the long-term care business can be confirmed. Conclusion: The low wage problem of long-term care workers such as care workers is not the only problem in Korea. In other countries, there are various wage support policies for employees. In particular, it is necessary to refer to the improvement in the treatment of care workers in Japan and wage pass-through in the United States. In addition to wages, there is a need to promote policies to provide employment motivation through efforts to improve their social status and improve their job status and career development for employees in long-term care facilities.

노인 외래 본인부담정액제가 노인의 의료이용 및 의료비 지출에 미치는 영향

나영균 ( Young-kyoon Na ),정형선 ( Hyoung-sun Jeong ),안보령 ( Bo-ryung Ahn ),이광수 ( Kwang-su Lee ) 한국보건경제정책학회 2016 보건경제와 정책연구 Vol.22 No.4

This study focused on the effect of fixed copayment program for elderly outpatients on medical utilization and health expenditure. The cohort data of National Health Insurance Service (NHIS) were analysed using difference-in-difference (DID) method with propensity score matching (PSM). The number of outpatient visits per capita per year increased in the case of test group than that of a control group, and their copayment per capita per year decreased, and their medical expenditures per capita per year increased showing statistically significant differences. This results suggest that fixed copayment program for elderly outpatients has contributed to elderly population`s access to healthcare by reducing their burden in their use of health care. This might include user`s moral hazard or providers` induced demand as well. Both access to health care of the elderly and stability of the national health insurance fund need to be considered in determining the upper limit of health expenditure and level of copayment in the fixed copayment program for elderly outpatients.

재가의료급여 시범사업 대상자의 재입원에 미치는 영향: 일반적 특성, 일상생활수행능력, 서비스 이용을 중심으로

임은실(Yim,Eun Shil),나영균(Na,Young-Kyoon),김아름(Kim,Areum),김기범(Kim,Kibeom),김보민(Kim,Bomin) 한국농촌간호학회 2024 한국농촌간호학회지 Vol.19 No.1

Purpose: This study identifies the factors influencing unplanned readmissions among participants of the medical aid community care pilot program. Methods: This descriptive study analyzed data from 1,013 participants in a medical aid community care pilot program. Data were analyzed using multiple logistic regression analysis. Results: The presence of mental illness, injury-related conditions, long-term care grades, and activities of daily living scores are key factors influencing the likelihood of readmission. In particular, the presence of a mental disorder or an injury-related condition increased the probability of readmission, whereas individuals with long-term care grades 1~2 showed a decreased likelihood of readmission. Conclusion: This study emphasizes the importance of enhancing the management of mental and injury-related conditions, effective utilization of long-term care services, and improvement of ADL scores to reduce readmission. These findings offer crucial insights for enhancing the efficiency of home medical care benefit programs and sustainable expansion of services.

노인장기요양보험제도의 복지용구대여제에 관한 연구: 서비스 이용자와 제공자의 표적집단면접조사(FGI)를 중심으로

권진희 ( Kwon Jinhee ),김혜경 ( Kim Hye-kyung ),나영균 ( Na Young-kyoon ) 한국보건사회연구원 2017 保健社會硏究 Vol.37 No.3

본 연구는 노인장기요양보험의 복지용구 대여서비스에 대한 조사를 통해 향후 복지용구 서비스의 정책방향에 필요한 제언을 목적으로 하였다. 조사는 서비스 이용가족을 대상으로 한 이용자 조사, 대여사업소를 대상으로 한 제공자 조사를 표적접단면접조사(FGI)를 통해 진행하였으며, 자료 분석은 질적내용분석방법(content analysis)을 사용하였다. 주요 연구결과는 다음과 같다. 첫째, 다양한 복지용구품목을 통해 질 높은 서비스제공에 대한 필요성이 서비스 이용자와 제공자 조사에서 공통적으로 제기되었다. 둘째, 이용자 조사 결과, 서비스 계약 체결 전 단계에서 경험적으로 복지용구를 이용해 보는 것에 대한 욕구가 도출되었다. 셋째, 제공자 조사를 통해 복지용구 대여의 사업성이 낮은 점과 장기요양급여제공기록지의 보완이 시급함을 알 수 있었다. 본 연구의 결과를 토대로 향후 복지용구 대여제에 대한 방향성을 확인할 수 있었으며, 향후 전국단위의 복지용구관련 실태조사 등을 통한 후속연구가 필요할 것이다. The purpose of this study is to analyze assistive devices rental service in the long-term care insurance. For our research purpose, we conducted focus group interviews between rental-agency and frail elders` family. Data was analyzed using content analysis method. The main results are follows. 1) Diverse product and product item should be developed to improve the quality of assistive product from both service-users and service-providers analyses. 2) The necessity of pre-use before contract was suggested from service-users analysis. 3) The efforts to improve poor business market and the standard long-term care utilization plan is needed from service-providers survey. Our findings could suggest the policy direction of assistive product rental under the long-term care insurance system. Further research focusing on assistive product should be conducted based on national wide survey.