의료전달체계 개선의 방향과 전략

Abstract

n Korea, the healthcare delivery system has been centered on the government’s agenda. With the introduction of nationwide health insurance in July 1989, the government’s healthcare delivery system (patient referral system of health insurance) began. The patient referral system of health insurance, which the government has continuously promoted, has only short-term effects and no long-term effects. The cause of the failure of the patient referral system is that the policy problem was wrong defined and only the policy by regulation was implemented. The evaluation of the Korean healthcare delivery system is currently good, although there is a patient concentration toward large hospitals in the capital area. However, the rapid aging, rapid increase in the medical use of the elderly population, and the entry into an era of low growth require improvement of the Korean healthcare delivery system. The definition of policy problem related to healthcare delivery system should be changed into people’s low preferences of local and small medical institutes, not patients concentration of large hospitals in the capital area because the definition of policy is not a phenomenon but a basic cause. The direction of improvement of the healthcare delivery system can be summarized by regionalization and specialization of medical institutions. In order to improve the healthcare delivery system, the policy strategy of support for regional medical institutions after evaluating regional health care should be given priority. And governmental proposals, as well as innovative proposals led by the private sector, should be accepted and tested, and those that pass the test should be officially implemented in the national health insurance. People could select among existing plans and new alternatives. In order to change the medical utilization based on the wants of the people, it is not to regulate the phenomenon of medical utilization, but to change the wants of the people. The change of people’s wants becomes gradually possible when the choice of the people is the basis