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KMID : 0387320070170010001
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Korean Journal of Health Policy and Administration
2007 Volume.17 No. 1 p.1 ~ p.27
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Reexamination of Patient’s Cost-sharing System for Oriental Medical Services in the Korean National Health Insurance
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Kim Jin-Hyun
Yoo Wang-Keun
Seo Dong-Min
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Abstract
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This study is designed to estimate an appropriate level of patient’s cost-sharing for oriental medical services in the Korean National Health Insurance. The findings of this study can be summarized as follows: 1) The current co-payment system for oriental medical services does not reflect its cost structure in clinical practice due to inconsistency of cost-sharing plan in the NHI. 2) Both oriental medical institutions and their patients, as a result, are at a relative disadvantage in financial burden, compared with other services. 3) The substantial proportion of patients’ cost-sharing depends on the amount of co-payment and the range of medical cost that a flat rate is applied to. 4) The extension of the range doesn’t make any substantial decrease in patient’s cost-sharing. 5) The fixed amount of co-payment is more sensitive than a range to total variations of patient’s cost-sharing. Based on the above, the budget impacts of a new co-payment system were estimated for each co-insurance rate, according to given scenarios. The results range from -59 billion Won (-8.5%) to 16 billion Won(2.3%).
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KEYWORD
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Oriental Medical Service, Co-payment, Financial burden, Cost-sharing
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