초록

본 연구는 건강보험에 대한 인식을 파악하여 치과 건강보험제도의 운영과 개선방안에 도움이 되고자 2006년 8월부터 10월까지 행정기관 및 임상전문가 568명과 의료기관에 내원한 의료소비자 1036명을 대상으로 설문조사를 실시하여 다음과 같은 결론을 도출하였다. 1. 전문가 집단의 인구 사회학적 특성에서 여성이 84.7%로 높은 비중을 차지하였으며, 연령은 20대, 30대, 40대 순으로 나타났다. 의료소비자 집단의 인구 사회학적 특성은 여성이 50.2%, 남성이 49.8%로 비슷한 분포를 나타냈으며, 연령은 20대, 30대,40대 순으로 나타났다. 2. 치과 건강보험의 재정확보에 관한 의견에 대해 조사한 결과 급여확대를 위한 재정수준에서는 전문가, 의료소비자 모두 '보험급여 재정수준을 늘여서 추가적으로 급여항목을 확대하되 우선순위도 재조정하자'는 의견이 높게 나타났다. 재원조달방법으로는 전문가의 경우 '정부 예산 지원비율 확대'와 '사회보장제도 마련', '지방자치단체의 예산편성' 순으로 나타났으며, 의료소비자의 경우 '정부의 예산 지원비율 확대', '지방자치단체의 예산편성', '소득수준에 따른 격차 확대' 순으로 나타났다. 3. 치과 건강보험에 대한 전반적인 견해에서 전문가는 비급여를 포함한 본인부담 비용의 적절성(2.47), 급여적용 항목수의 적절성(2.29) 순이었으며, 의료소비자의 경우 전체 건강보험 예산 중 치과 건강보험의 급여비율의 적절성(2.26), 급여적용 항목수의 적절성(2.16) 순을 기록하였다. 우선순위 설정 기준이 필요하다는 의견에서는 각각 3.75, 2.93을 나타냈다. 4. 치과 건강보험에 관한 인식도에 있어서 전문가와 의료소비자 모두 비슷한 의견을 보였으며, 특히 치과건강보험 제도에 대한 필요성을 크게 인식하고 있었다. 만족도에 있어서는 두 집단 모두 만족도가 모든항목에서 3점 이하로 불만족하는 경향을 보였으며, 특히 보험적용 항목에 대한 만족도가 가장 낮았다.

The purpose of this study was to examine people's awareness of health insurance in a bid to help improve the management of dental health insurance coverage. The subjects in this study were 1,036 people who included experts in that field and medical consumers. The findings of the study were as follows: 1. In regard to the demographic characteristics of the expert group including gender and age, the female experts outnumbered the males, as the former accounted for 84.7 percent. And the experts in their 20s made up the largest age group, followed by the 30-39 age group and those in their 40s. As to the demographic characteristics of the medical consumers, the rates of the men and women stood at 49.8 percent and 50.2 percent respectively, which were similar. By age, the largest number of the medical consumers were in their 20s, followed by in their 30s and in their 40s. 2. Concerning opinions on the procurement of finance for health insurance, many respondents in both groups agreed that the health insurance coverage should be enlarged by securing more finance, and that items involved in the coverage should be prioritized again. Regarding a means of securing financial resources, the experts placed the most emphasis on extended budgetary support from the government, followed by establishing a social security system and budget compilation by local governments. The medical consumers attached the most importance to extended budgetary backing from the government, followed by budget compilation by local governments and determining contribution according to income level. 3. As for general view of the dental health insurance, the experts believed that the amounts of copayment and self-payment by the insured were appropriate(2.47), and they found the number of benefitted items to be proper(2.29) as well. The medical consumers thought that the benefit percentage of the dental health insurance in the overall health insurance budget was appropriate(2.26), and they also considered the number of benefitted items adequate(2.16). But this group didn't give a lot of marks to the appropriateness of those things. 4. As to perception about the dental health insurance, both groups took a similar view of it. Specifically, they felt the strong need for a dental health insurance system. In terms of satisfaction level, both groups were dissatisfied with it, and there was a strong tendency for them to be discontented with the health insurance coverage.

키워드

• Dental health insurance coverage;
• Awareness;
• Specialist;
• Medical consumer;