지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
오류제보하기
Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.
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참고문헌 (44)
참고문헌 신청
Huh SI / 2008 / Policy issues on the limited coverage of the national health insurance / Health Welfare Forum 140:22~38
허순임 / 2009 / 우리나라 건강보험 보장성 개선 정책에 대한 평가 / 보건행정학회지 19(3):142~165
Choi JK. / 2008 / The problem and the solution of NHI benefit package: focus on arbitrary uninsured benefits / Healthc Policy Forum 6(4):91~97
Choi KC / 2010 / Evaluation of NHI benefits policy(2005-2007)and review for subjects of expansion / Health Insurance Policy 9(2):66~79
Huh SI / 2007 / Plan for securing optimum level of NHI benefit / Korea Institute for Health and Social Affairs
허순임 / 2009 / 우리나라 건강보험 보장성 개선 정책에 대한 평가 / 보건행정학회지 19(3):142~165
Choi JK. / 2008 / The problem and the solution of NHI benefit package: focus on arbitrary uninsured benefits / Healthc Policy Forum 6(4):91~97
Choi KC / 2010 / Evaluation of NHI benefits policy(2005-2007)and review for subjects of expansion / Health Insurance Policy 9(2):66~79
Huh SI / 2007 / Plan for securing optimum level of NHI benefit / Korea Institute for Health and Social Affairs
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