아동 건강전담의 건강보험 시범사업 모형개발

Abstract

The purpose of this study was to review the necessity of introducing a systematic child health management system at the national level and to develop a pilot project operation model to operate as a health insurance system. The research method analyzed the medical use of pediatric and adolescent patients and the status of medical resources using medical expense claims data and medical institution reports, and reviewed the subjects and target institutions dedicated to participate in pilot projects. As a result of comprehensive consideration of expert opinions, it was suitable for children's ages and ages 0 to 2 who frequently visit pediatrics and adolescents to allow more children to participate in the project early in the project and to increase parental satisfaction. In addition, five criteria were selected as medical institutions that can participate in the pilot project in consideration of children's equity in participation in the project and regional deviation, and other pilot project service contents, service cycle, and cost were presented. Finally, the pilot project effectiveness evaluation index was set, and the index was set as input, activity, and calculation process.