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아동 건강전담의 건강보험 시범사업 모형개발

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Type
Research report
Author(s)
강경림예례미이정은권오탁
Issued Date
2022-09
Keyword
아동주치의아동건강관리시범사업pilot projectchild healthinputactivitycalculation
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.
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/3002
Alternative Title
Development of a Model of Health Insurance Pilot Project for Children's Health
Table Of Contents
요약 ··························································································· ⅰ

제1장 서론 3
1. 연구 배경 ······························································································ 3
2. 연구 목적 ······························································································ 4
3. 연구 내용 및 방법 ·················································································· 5
4. 연구 수행체계 ························································································ 6

제2장 국내외 건강전담의 사업 현황 9
1. 국내 아동 및 청소년 건강전담의 사업 현황 ··············································· 9
2. 서울시 우리아이 주치의 제도 ································································· 10
3. 수원시 아동담당의 의료지원 사업 ··························································· 13
4. 기타 지차체 아동 건강주치의 제도 사업 현황 ·········································· 16
5. 영국 아동건강관리체계 ·········································································· 17
6. 마국 어린이건강보험프로그램 ································································· 25
7. 소결 ···································································································· 27

제3장 국내 아동인구와 소아청소년과 진료 현황 31
1. 개요 ···································································································· 31
2. 아동인구 현황 ······················································································ 33
3. 소아청소년과 의료이용 현황 ·································································· 37
4. 소아청소년과 의료 자원 및 인력 현황 ···················································· 47
5. 소결 ···································································································· 51

제4장 아동 건강전담의 시범사업 운영 모형개발 55
1. 운영 방향 및 목표 ················································································ 55
2. 시범사업 운영 모형(안) ········································································· 55
3. 시범사업 운영 전산 시스템(안) ······························································· 72

제5장 아동 건강전담의 시범사업 효과평가 방향 77
1. 평가 필요성 ························································································· 77
2. 평가 내용 및 방법 ················································································ 77
3. 평가지표 및 산출방안 ··········································································· 78

제6장 고찰 및 결론 85

◾ 참고 문헌 ····················································································· 87
◾ ABSTRACT ·················································································· 89
Publisher
건강보험심사평가원
Location
KOR
Citation
강경림 et al. (202209). 아동 건강전담의 건강보험 시범사업 모형개발.
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