치과의사의 의료보험진료비와 소득에 미치는 요인

Abstract

[한글]

본 연구는 치과의사의 의료보험진료비와 소득에 미치는 요인을 조사하기 위하여 전국의 치과의사를 모집단으로 1000명을 표본추출하여 설문조사한 결과 306명의 응답자중에서 '96년도 의료보험진료비 청구현황이 분석가능한 개원치과의사 279명을 대상으로한 단면연구와 치과의사의 특성, 개원형태, 진료형태, 진료환경을 독립변수로 하고 월평균소득과 치과의사 1인당 의료보험진료비를 종속변수로 다중회귀분석을 실시하였다.

연구의 주요결과는 다음과 같다.

1. 월평균소득에 영향을 미치는 요인으로는 보조원수(위생사+조무사) 1명을 증가시키면 72만5천원의 월평균소득이 증가하는 것으로 유의한 차이가 있다.

2. 치과의사 1인당 월평균 의료보험진료비에 미치는 요인으로 강도(업무량/시간) 1단위 증가시키면 4만1천원 증가하고, 보조원수(위생사+조무사) 1명을 증가시키면 28만7천원 증가, unit chair 1대 증가는 51만 7천원 증가하는 것으로 유의하게 나타났다. 나이 1세증가는 음의 회귀계수로 4만6천원이 감소하고, 치과의사 1명증가는 음의 회귀계수로 219만원 감소하며, 개원지역이 서울시인 경우가 기타 시지역보다 106만원 감소하는 것으로 유의한 차이가 있다.

3. 치과의사 월평균소득은 성별, 나이, 수련여부, 치과의사수, unit chair 수,의료보험 건당진료비, 월비급여환자수, 월진료시간, 강도, 개원지역별로는 유의한 차이가 나타나지 않았다.

4. 월평균소득과 치과의사 1인당 의료보험진료비는 상관관계가 있는 것으로 분석되었다.

이상의 연구결과를 종합하면 치과의사 월평균소득에 영향을 미치는 보조원수와 치과의사 1인당 의료보험진료비에 영향을 미치는 보조원수, unit chair수는 개원형태로 신규개원시 신중히 고려할 요인이다. 그러나 본 연구는 단면연구로서 인과관계 등을 분석할 수 없는 한계가 있으므로 앞으로 코호트연구 등을 통하여 지속적으로 치과의사의 소득에 대한 연구가 이루어져야 한다고 사료된다.

[영문]

This study is to investigate how several facfors have an influence on the medical insurance treatment charges, and the income of dentists. One thousand dentists were selected as a sample from all those throughout korea. Among them, 306 dentists responded to the questionaire. A sectional study was conducted for 279 dental practitioners for whom it was possible to analyze the bill for medical insurance treatment. The characteristics and personality of dentists, as well as his diagnostic type and environment, were used as an independent variable. Whereas the average monthly income and medical insurance treatment charge per dentist were used as dependent variables to conduct a multiple regression analysis.

The major result of the study is as follows:

1. Average monthly income was influenced by whether a dentist had more than one assistant. One more assistant(hygienists+dental assistants) increases the average monthly income by 725,000 won. This represents a significant relation.

2. Average monthly medical insuranee treatment charge per dentist was in fluenced by a for ther factor; one more unit of dentist strength(quantity of service/hour) increases these charges by 41,000 won. And one more assistant(hygienists+dental assistants) increases it by 287,000 won. One more unit chair increases it by 517,000 won. This also represents a significant relation.

As for the age of the dentist, the monthly medical insurance treatment charge decreases by 46,000 won in terms of the significant regression coefficient if the dentist is one year older. One more dentist increases it by 2,190,000 won in terms of the minus regression coefficient. The monthly medical insurance treatment charge to be incurred by a dental practitioner in Seoul decreases by 1,060,000 won as compared with a dental practitioner in other areas. This also represents a significant relation.

3. The gender, age, dental apprenticeship, number of dentists, as well as the number of chairs, unit medical insurance treatment charges, and monthly wage have no significant relation with the monthly average income of dentists.

The number of patients, monthly service hours, service strengths and location of dental clinics did not have any significomt relation either with the monthly average income of dentists.

4. The medical insurance treatment charge to be incurred by one dentist has relation with his monthly average income.

The number of dental assistants having influence on the average monthly income of dentists, as well as the number of dental assistants and unit chairs having influence on the medical insurance treatment charge to be incurred by one dentist should be carefully considered by the dentist who opens his dental clinic. Since, however, this section cannot analyze these casual relations, it is required to continue to study the income of dentists through the Cohort study.