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醫療給與에 關한 制度的 考察

A Study of Medical Care Supply and Demand System

공중보건잡지 1970년 7권 1호 p.393 ~ 405
최종군 (  ) - 서울대학교 보건대학원

Abstract


The records of activities concerning the supply of and demand for medical care were surveyed through visits to the Ministry of Health and Social Affairs, the Office of Labor Affairs, the Ministry of Government Administration, and the Korea Automobile Insurance Co., Ltd. from September 5 to October 20, 1969. As results, the following conclusions were reached:
1) The kinds of sicknesses of the Korean people differ between the urban and rural area. The percentage of respiratory system diseases is remarkably higher in urban areas than in rural areas. Other typical diseases in urban areas are diseases of the digestive system, symptomatic senility, undiagnosable conditions, and diseases of the nervous system, and sense organs in that order. Most of the diseases in rural areas are diseases of respiratory system, diseases of digestive system, senility, and undiagnosable conditions. Other common diseases in rural areas are diseases of the nervous and sense organs and diseases of skin and loose connective tissues
2) The average daily prevalence rate is 9.2 per cent in urban areas and 11.0 per cent in rural areas. The monthly prevalence rate is 24.8 per cent in urban areas, and 20.8 per cent in rural areas. The incidence rate is 7.1 per cent in urban areas and 11.5 per cent in rural areas.
3) The ratio of demand for medical care is high at 81.6 per cent in urban areas, and relatively low at 51.1 per cent in rural areas.
4) Medical expense amounts to 732 won in urban areas per case, and 788 won in rural areas. The expense per capita reached 148 won in urban areas and 84 won in rural areas The amount par household was 798 won in urban areas and 488 Won in rural
5) The results of pilot medical insurance activities were satisfactory. However, only 5,028 persons were insured during the pilot activity period. The government subsidies for the project made up 15.7 Per cent of the total project expenses in 1968 comprising the office expenses and grant. The average monthly amount of insurance premium n 280 yon while the average monthly benefit of insurance money is 580 won.
6) During 1965, insurance benefit was issued in an average monthly total of 1,735 cases, and the average amount issued per casts was 398 won.
7) As of the end of August 1969, the number of enterprises or places of work obliged to conclude workmen´s compensation programs reached 3,302 involving a total of 663,237 employees.
8) The insurance premium collection ratio was 90.1 per cent during 1968, and the ratio of receipt to payment 72.9 per cent. This indicates the underpaid operation of the insurance system.
9) The payment of medical treatment under workmen´s compensation is confined to cases requiring 10 or more days of therapeutical treatment. The average annual amount of therapeutical expenses in 12,760 won per case. The average issue of therapeutical expenses reached 21,468 won per case in 1964, 9,880 won in 1965, and 13, 354 won in 1968. The average amount issued in medical treatment per case was thus greater than the amount of general medical expenses, thereby indicating that good medical care was rendered to the insured.
10) As of the end of 1967, the total number of government employees was 353,287. Its average yearly increase rate was 5.9 per rent during the 1960-67 period, while the average retirement rate was 6.7 percent
11) The ratio of paid insurance benefit to the government pension income was highest at 71.4 per cent in 1967 reached, the highest level of 52.1 per cent in 1965, and was lowest at 9.8 per cent in 1962.
12) The average annual financial burden per government employee is 2,218 (185 won per month),and the receipt Per government employee was 342 won in 1962, increasing to 2,968 won in 1967.
13) The average annual amount issued in insurance benefit per case reached 3,295 won in 1962, and 43,397 won in 1967.
14) The average amount paid in insurance benefit to sick or injured government employees per case was 1,921 in 1962, and has since yearly increased, reaching 16,721 in 1967. This amount is greater than the corresponding amount of 13,354 paid under the workmen´s compensation insurance. Thus, better medical care was rendered to the government employees.
15) The ratio of government employees contracting diseases or injured in line of on- duty reached 34.5 per cent in 1962, and increased to 62.2 per cent in 1967.

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