Korean Journal of Medical Ethics
The Korean Society for Medical Ethics
Article

민간보험 도입 후 개원의사들이 느끼는 진료환경의 변화

이성원1, 신건희1, 최은영1, 박일환1, 송후빈2, 정유석1,3,*
Sung-Won YI1, Gun-Hee SHIN1, Eun-Young CHOI1, Eal-Whan PARK1, Hu-Bin SONG2, Yoo-Seock CHEONG1,3,*
1단국대학교 의과대학 부속병원 가정의학교실
2충청남도 의사회
1Department of Family Medicine, Dankook University Hospital, Dankook University College of Medicine
2Chungnam Medical Association
3Department of Family Medicine, Dankook University College of Medicine
*교신저자: 정유석. 단국대학교 의과대학 가정의학교실. Tel: 041-550-6385. Fax: 041-559-7940. e-mail: drloved@hanmail.net

ⓒ Copyright 2015 The Korean Society for Medical Ethics. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Dec 08, 2014; Revised: Dec 10, 2014; Accepted: Dec 19, 2014

Published Online: Mar 31, 2015

요약

민간의료보험의 도입 이후 의사들의 진료패턴의 변화가 불가피해졌다. 연구자들은 2014년 10월 충청지역 개원의사들 87명(온라인 18명, 오프라인 69명)을 대상으로 민간의료보험의 진료부담, 장단점에 대한 설문을 실시하였다. 연구 결과, 임상의사들은 민간의료보험 관련한 진료에 대해서 환자들의 건강에는 그다지 긍정적이지 않은 반면(47.1%), 일정 부분 이상 진료에 부담감을 느끼고 있었다(90.9%). 민간의료보험의 활성화가 의사-환자 관계에 미치는 영향 역시 부정적(79.2%)이라는 응답이 긍정적(4.6%)이라는 응답보다 훨씬 높았다. 병의원의 경영에는 별 도움이 되지 않는다는 응답이 많았으며(58.6%), 진료의 객관적이고 양심적인 판단에도 72.4%가 부정적 영향을 준다고 하였다. 민간의료보험에 대한 전반적 평가 항목에서는 부작용이 큰 제도라는 견해(50.6%)와 부작용이 있지만 감내할 만하다(49.4%)라는 견해가 비슷한 비율로 나온 반면, 국민건강에 기여하는 좋은 제도라는 항목에는 동의하는 응답자가 없었다. 해결책으로는 ‘민간의료보험의 부정적 기능을 보완하기 위한 의료ㆍ보험회사ㆍ정부ㆍ환자 간 협의체가 필요하다’는 견해가 많았다(48.2%).

ABSTRACT

After the introduction of private insurance, there have been significant changes in clinical practice patterns. In October 2014, 87 private practitioners from the Chungcheong province participated in our survey (18 on-line, 69 off-line). The survey focused on the positive and/or negative effects of private insurance on clinical environment. The results of our survey show that almost half (47.1%) of private practitioners replied that although private insurance doesn't seem to benefit patients’ health, the majority (90.9%) feel private insurance puts added pressure to their practice. The 79.2% replied that the effect of private insurance on the doctor-patient relationship is negative compared with only 4.6% saying it had a positive effect. The 58.6% replied that private insurance had little or no impact on hospital management and 72.4% replied that private insurance negatively affected objective and conscientious decision making. Overall, 50.6% of our participants replied that the private insurance system was flawed with negative side effects, while 49.4% replied that despite its flaws the private insurance system was bearable. No participants felt the private insurance system was positive and benefited the national insurance system. The 48.2% of participants voiced the need for a governing network between health services, private insurance companies, patients and the government.

Keywords: 민간보험; 의사-환자 관계; 이해상충
Keywords: private insurance; doctor-patient relationship; conflict of interest