(A) study on satisfaction with health examination by national health insurance corporation

보건정책및관리학과/석사[한글] 본 연구는 국민의 건강복지 증진을 위한 건강검진에 대한 새로운 개선방안을 수립하고 건강보험공단에서 실시하는 건강검진에 대한 만족도 제고방안을 마련하고자 실시되었다. 2001년부터 2003년 사이에 건강보험 건강검진을 받은 적이 있는 수검자로서 서울에 위치한 국민건강보험공단 강서지사 내 4개 사업장에서 임의로 추출한 250명의 직장가입자와, 강서지사를 방문한 민원인 가운데 선정된 지역가입자 100명에 대하여 2004년 5월 3일부터 5월 21일까지 강서지사의 민원담당자가 내방 민원인에 대하여 직접면접 조사를 실시하였다. 최종 조사가 완료된 대상자수는 직장가입자 213명과 지역가입자 84명으로 총 297명이었다. 공단 건강검진을 수검하는 계기로는 공단의 안내문을 보고 검진을 받았다는 응답자가 35%로 가장 많았고, 공단 검진 후 결과를 통보받은 경험은 64%만이 있었다. 2차 정밀검사를 받은 경우는 11%로 매우 적었다. 2차 정밀검사를 받지 않은 이유로는 시간이 없어서가 23%, 공단제공 2차검진 사실을 몰라서가 19%, 유소견자라도 질병이 없다고 생각해서가 19%였다. 자비건강검진 경험여부에 대해서는 응답자 중 40%가 경험이 있다고 응답하였고, 건강이 염려되어 받았다고 응답한 사람이 50%였다. 자비 건강검진 연평균 비용은 10만원 미만이 36%로 가장 많았다. 건강보험공단 건강검진과 자비 건강검진의 만족도를 비교한 결과는 10개 문항의 질문에 대해 건강보험공단 건강검진은 5점 만점에 평균 3.07점, 자비 건강검진은 3.50점으로 유의한 차이를 보였다. 건강보험공단 건강검진 만족도에 대해서는 건강검진에 대한 일반적인 태도만이 유의하게 영향을 미치는 변수였고, 자비 건강검진 수검에 영향을 미치는 요인으로는 건강 매우 건강한 사람이 건강상태가 좋을수록 자비검진을 받을 가능성이 낮고, 공단 검진에 대한 만족도 수준이 높을수록 자비검진을 받을 확률이 낮으며, 건강검진에 대한 일반적인 태도가 긍정적일수록 자비검진을 받을 확률이 높았다. 분석결과를 종합하면, 공단 건강검진이 자비 건강검진보다 만족도가 다소 낮은 것을 알 수 있었다. 건강보험의 검진만족도를 개선하고 국민건강에 대한 기여도를 향상시키기 위해서는 공단의 총체적인 노력이 필요하며, 공단 뿐만 아니라 의료인과 의료기관, 정부까지 이 사업의 중요성을 인식하여 적극적인 협력체제를 유지하고, 실효성 있는 건강검진사업이 되도록 과감한 투자와 개선이 필요하리라 생각된다. [영문]This study aimed at suggesting a new way of providing health examination to improve national health and welfare, searching for practical schemes for follow-up management, and finding a way to enhance satisfaction with health examination through comparison with members who receive additional health examination at their own expense. A survey was carried out with samples from four work sites within the Gangseo branch of the National Health Insurance Corporation in Seoul and from those who visited the branch between 2001 and 2003. Occupational members in 2004 were provided with a self-administrated questionnaire by one in charge of health insurance at each work place; regional members went through a direct interview with a civil affairs official in the Gangseo branch between May 3 and 21, 2004. A total 297 members completed the survey: 213 occupational members and 84 regional members. 35 percent of respondents, the largest percentage, were found to have received examination by the corporation to see a guide in the corporation, and only 64 percent answered that they had an experience in being notified the results of the examination by the corporation. And only 11 percent were found to have participated in the secondary close examination. They didn''t receive the secondary close examination because they lacked time (23%), didn''t know the need of the secondary examination (19%), and thought of themselves as healthy even if they were patients (19%). 40 percent answered that they had an experience in receiving health examination at their own expense; among them, 50 percent were found to have received it with worry about their health. 36 percent, the largest percentage, answered the cost of health examination averaged less than 100,000 won a year. After comparing health examination by the National Health Insurance Corporation with that at one''s own expense in terms of satisfaction, there was a significant difference, 3.07 for health examination by the corporation and 3.50 the examination at one''s own expense on the average; the only factor significantly affecting satisfaction with health examination by the corporation was a general attitude toward health examination while those who were healthy or very healthy, were less satisfied with that by the corporation, and generally had more positive attitude toward health examination were found to go through the health examination at one''s own expense. Putting these results of the analysis together, there was lower satisfaction with health examination by the corporation than the examination at one''s own expense. To enhance satisfaction with examination by health insurance and improve its contribution to national health, the corporation should exert all efforts, and medical professionals, medical institutions, and the government as well as the corporation should understand that this is an important project, maintain a positive cooperative system, and make great investment and improvement to make it an effective health examination project.ope