민간의료보험 가입이 의료비에 미친 영향 :실손의료보험을 중심으로

초록

It is a continued assertion that medical insurance for actual expense causes unnecessary medical demand to increase personal medical expense and worsen the financial condition of national health insurance. The study analyzed if buying new medical insurance for actual expense increased personal medical expense based on the 7th year (study period from Feb. ~ Jul., 2012) and 9th year (study period from Mar. ~ Sep., 2014) data of Korea Health Care Panel Study using difference- in-differences model. As a result of the analysis, no significant increase was found in medical expense of new fixed-return policyholders, compared with non-policyholders (p>0.05). But, new actual- expense-indemnity policyholders were found to experience significant increase in non-payment item (p=0.008), prescription drug expense including transportation expense (hospitalization nursing fee)’(p=0.046), and resin filling treatment expense (national health insurance payment + statutory payment by policyholding patient + non-payment item)’(p=0.026), compared with new fixed-return policyholders. Also, new actual-expense-indemnity policy holders experienced additional significant increase in total medical expense (national health insurance payment + statutory payment by policyholding patient + non-payment item + prescription drug expense including transportation expense (hospitalization nursing fee) (p=0.028), compared with non-policyholders. Consequentially, this study found that buying new medical insurance for actual expense increased personal medical expense and national health insurance spending. Such increase in medical expense will need to be assessed for its appropriateness and a proper measure will be required regarding the medical expense increase caused by private insurance holding.

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