ABSTRACT

The purpose of this study is to evaluate the impact of marketization on the quality of services of long-term care insurance program. We exploit the impact of the provider competition and user's selection as market logic on the quality of service. A merged dataset combining surveys from 248 Long-Term Care facilities and online resources from NHIC administrative for NLTCI(National Long-Term Care Insurance) was used and analyzed by multiple regression and negative binomial regression. Unlike the policy intention of Long-Term Care program, empirical findings indicate that the effect of the service provider's competition on the quality of service isn't statistically significant. However, user's choice appears increasing the quality of service. Implications as an initial research is the user's choice which is showed by policy effect have a limited user's service selectivity to enter the institution of one's choice since there is a long queue. The quasi-market like long-term care insurance service depends on the government's institutional arrangement in various stakeholder like service delivery entity and user who involved in the market to provide and receive stable services. Therefore government's prudent and responsible decision-making is required.

KEYWORD

Long-Term Care Insurance program, marketization, competition, user choice, quality of service, quasi-market

REFERENCES(46)open

  1. [jounal] 강혜규 / 2008 / 사회서비스 확대정책과 지역사회 사회복지서비스 공급체계 / 상황과 복지 25 : 67 ~ 98

  2. [report] 강혜규 / 2006 / 한국의 사회서비스 쟁점 및 발전전략

  3. [jounal] 김용득 / 2008 / 사회서비스 정책의 동향과 대안 - 시장 기제와 반-시장 기제의 통합 - / 사회복지연구 (36) : 5 ~ 28

  4. [jounal] 김인 / 2010 / 사회복지 서비스 전달에 있어서 바우처 제도의 시장 경쟁성과 수급자 선택권이 서비스 질에 미치는 영향 / 한국행정논집 22 (2) : 397 ~ 425

  5. [jounal] 김순양 / 2004 / 지방정부 행정서비스의 민간위탁 시스템 분석: 복지서비스를 중심으로 / 사회보장연구 20 (2) : 27 ~ 56

  6. [confproc] 김종해 / 2008 / 사회서비스의 시장화, 무엇을 위한 것인가 in 『한국 사회복지 발전전략의 재검토: 국가, 시장, 제3섹터의 재구조화를 중심으로 / 한국사회복지학회 2008 춘계학술대회자료집 : 105 ~ 122

  7. [jounal] 노시평 / 2007 / 공공서비스의 민간위탁공급에 관한 연구 - 익산시 장애인종합복지관 민간위탁과정을 중심으로 - / 한국거버넌스학회보 14 (2) : 175 ~ 202

  8. [jounal] 석재은 / 2010 / 공급자 관점에서의 노인장기요양보험제도의 개선방안 / 보건복지포럼 168 : 34 ~ 44

  9. [confproc] 선우덕 / 2012 / 노인요양서비스공급체계의 공공성 강화 방안 in『한국사회복지공급체계와 공공성』 / 한국사회복지정책학회 2012 춘계학술대회자료집 : 43 ~ 61

  10. [jounal] 정무성 / 2007 / 2007년 사회복지시설 평가 방향과 과제 / 월간 복지동향 105 : 21 ~ 23

  11. [confproc] 주은선 / 2012 / 국민연금기금의 사회복지서비스 투자 방안과 사회적 효용: 서비스 공급체계에 대한 투입을 중심으로 / 한국사회복지공급체계와 공공성』. 한국사회복지정책학회 2012 춘계학술대회자료집 : 117 ~ 152

  12. [jounal] 양난주 / 2009 / 노인돌보미바우처 정책집행분석 -선택과 경쟁은 실현되는가?- / 한국사회복지학 61 (3) : 77 ~ 101

  13. [jounal] 양난주 / 2010 / 한국 사회복지서비스의 변화 -행위자간 관계의 분석- / 한국사회복지학 62 (4) : 79 ~ 102

  14. [jounal] 이미진 / 2011 / 노인 장기요양서비스의 질 측정상의 쟁점에 대한 고찰 / 사회복지정책 38 (1) : 141 ~ 165

  15. [jounal] 이윤경 / 2010 / 이용자 관점에서의 노인장기요양보험제도의 평가 및 개선방안 / 보건복지포럼 168 : 25 ~ 33

  16. [jounal] 이진숙 / 2011 / 시장원리 확대를 통한 노인장기요양서비스의 효과성 평가 / 보건사회연구 31 (4) : 5 ~ 33

  17. [web] 국민건강보험공단 / 노인장기요양보험

  18. [web] 보건복지부 / 2012 노인복지시설현황

  19. [book] Anttonen, Anneli / 2013 / Marketisation in Nordic eldercare: a research report on legislation, oversight, extent and consequences : 13 ~ 22

  20. [jounal] Amirkhanyan, Anna A / 2008 / Does the public sector outperform the nonprofit and for?profit sectors? Evidence from a national panel study on nursing home quality and access / Journal of Policy Analysis and Management 27 (2) : 326 ~ 353

  21. [jounal] Castle, Nicholas G / 2005 / Nursing home closures and quality of care / Medical Care Research and Review 62 (1) : 111 ~ 132

  22. [jounal] Castle, Nicholas G / 2007 / Have Nursing Home Compare quality measure scores changed over time in response to competition / Quality and Safety in Health Care 16 (3) : 185 ~ 191

  23. [jounal] Castle, Nicholas G / 2010 / What is nursing home quality and how is it measured / The Gerontologist 50 (4) : 426 ~ 442

  24. [jounal] Cohen, Joel W / 1996 / The effect of Medicaid reimbursement on quality of care in nursing homes / Journal of Health Economics 15 (1) : 23 ~ 48

  25. [other] Ching, Andrew / 2006 / Regulations in Nursing Home Markets: Estimation of a Competitive Model

  26. [jounal] Davis, Mark A / 1991 / On nursing home quality: A review and analysis / Medical Care Research and Review 48 (2) : 129 ~ 166

  27. [book] Donabedian, Avedis / 1980 / The Definition of Quality and Approaches to Its Assessment [=Explorations in Quality Assessment and Monitoring, vol. 1] / Health Administration Press

  28. [jounal] Donabedian, Avedis / 1988 / The Quality of Care: How Can it Be Assessed / Journal of American Medical Association 260 (12) : 1743 ~ 1748

  29. [report] Forder, Julien / 2011 / Competition in the English nursing homes market

  30. [jounal] Gage, H / 2009 / Why are some care homes better than others? An empirical study of the factors associated with quality of care for older people in residential homes in Surrey / England Health and Social Care in the Community 17 (6) : 599 ~ 609

  31. [jounal] Gammonley, Denise / 2009 / Social service staffing in US nursing homes / Social Service Review 83 (4) : 633 ~ 650

  32. [jounal] Grabowski, David C / 2003 / Competitive spillovers across non-profit and for-profit nursing homes / Journal of Health Economics 22 (1) : 1 ~ 22

  33. [jounal] Grabowski, David C / 2004 / A longitudinal study of Medicaid payment, private-pay price and nursing home quality / International Journal of Health Care Finance and Economics 4 (1) : 5 ~ 26

  34. [jounal] Grabowski, David C / 2004 / Nursing homes with persistent high and low quality / Medical Care Research and Review 61 (1) : 89 ~ 115

  35. [jounal] Hillmer, Michael P / 2005 / Nursing Home Profit Status and Quality of Care: Is there any evidence of an association / Medical Care and Research and Review 62 (2) : 139 ~ 166

  36. [jounal] Le Grand, Julian / 2011 / Quasi-Market versus State Provision of Public Services: Some Ethical Considerations / Public Reason 3 (2) : 80 ~ 89

  37. [book] Long, J. Scott / 2006 / Regression models for categorical dependent variables using Stata / Stata Press books

  38. [jounal] Kadoya Yoshihiko / 2010 / Managing the Long-Term Care Market: The Constraints of Service Quality Improvement / Japanese Journal of Health Economics and Policy 21 (E1) : 247 ~ 264

  39. [jounal] Knox, Kris Joseph / 2006 / Comparative performance and quality among nonprofit nursing facilities in Texas / Nonprofit and voluntary sector quarterly 35 (4) : 631 ~ 667

  40. [jounal] Sangl, Judith / 2005 / Challenges in measuring nursing home and home health quality: lessons from the First National Healthcare Quality Report / Medical care 43 (3) : 1 ~ 24

  41. [jounal] Starkey, Katie B / 2005 / Market competition and quality of care in the nursing home industry / Journal of health care finance 32 (1) : 67 ~ 81

  42. [jounal] Steffen, Teresa M / 1997 / Organizational determinants of service quality in nursing homes / Hospital & health services administration 42 (2) : 179

  43. [jounal] Zhou, Yanfei / 2004 / The Home Help Industry in Japan: Market Concentration, Efficiency and Quality / JCER Economic Journal(Nihon Keizai Kenkyu) 49 : 173 ~ 187

  44. [jounal] Zinn, Jacqueline S / 1993 / Variations in the outcomes of care provided in Pennsylvania nursing homes: Facility and environmental correlates / Medical Care 31 (6) : 475 ~ 487

  45. [jounal] Zinn, Jacqueline S / 1994 / Market competition and the quality of nursing home care / Journal of Health Politics, Policy and Law 19 (3) : 555 ~ 582

  46. [jounal] Zinn, Jacqueline / 2009 / Determinants of performance failure in the nursing home industry / Social Science & Medicine 68 (5) : 933 ~ 940