Moon Byunggeor
Sungkyunkwan University, School of Global Leader & Department of Public Administration & Graduate School of Governance, South Korea.
Int J Integr Care. 2022 May 31;22(2):18. doi: 10.5334/ijic.6465. eCollection 2022 Apr-Jun.
This study analyzes the potential effects of a reform based on community integrated care in Korea, which is experiencing a high rate of population aging, and a specific method for financial integration. We first analyze the size and trend of funds used for the care for the elderly out of Korea's health insurance, long-term care insurance, and national budget. We then analyze the amount of financial resources required and the cost-saving effect when the related financial resources are converted into local community care funds. This approach sheds light on the possibility of harmonizing healthcare policy for the elderly and integrated care under the existing insurance system and suggests a direction for reform in policies pertaining to healthcare for the elderly. Given that the same services are provided, we find that combining the finances from the insurance and the national budget would result in a fund of KRW 2.6 trillion to KRW 4.7 trillion. This approach also confirms that health care costs for the elderly can be reduced by 1-5% in the long term, which we estimate to be between KRW 1 trillion to KRW 4 trillion by 2050. We find that by tapping into the national budget to manage the pre-medical stage care, we can utilize an efficient operation mechanism unlike insurance. We also confirm that information exchange and harmonious operation between the national budget and state-run insurance as well as feedback and incentives through performance management are necessary for these results to become a reality.
本研究分析了在韩国这种人口老龄化率较高的情况下，基于社区综合护理的改革的潜在影响以及一种具体的财务整合方法。我们首先分析了韩国医疗保险、长期护理保险和国家预算中用于老年人护理的资金规模和趋势。然后我们分析了相关财务资源转换为地方社区护理基金时所需的财务资源量和成本节约效果。这种方法揭示了在现有保险体系下协调老年人医疗政策和综合护理的可能性，并为老年人医疗政策的改革提出了方向。鉴于提供的是相同的服务，我们发现将保险和国家预算的资金合并将产生2.6万亿韩元至4.7万亿韩元的基金。这种方法还证实，从长期来看，老年人的医疗费用可降低1%至5%，我们估计到2050年这一数字在1万亿韩元至4万亿韩元之间。我们发现，通过利用国家预算来管理医疗前阶段的护理，我们可以采用一种不同于保险的高效运营机制。我们还证实，国家预算与国营保险之间的信息交流与和谐运作，以及通过绩效管理进行反馈和激励，对于这些结果成为现实是必要的。
