한국의료질향상학회지 (Quality Improvement in Health Care)

  • 제29권1호
  • /
  • Pages.26-42
  • /
  • 2023
  • /
  • 1225-7613(pISSN)
  • /
  • 2288-078X(eISSN)
한국의료질향상학회 (Korean Society for Quality in Health Care)
권호 표지
DOI QR코드

DOI QR Code

의료기관 대상 코로나19 재정지원 제도의 효과 평가: 심층 인터뷰 결과를 중심으로

Perceptions of Government Subsidy Programs for Reimbursing Financial Losses of Hospitals due to COVID-19: An In-Depth Interview

  • 윤은지 (건강보험심사평가원 심사평가연구소) ;
  • 안보령 (건강보험심사평가원 심사평가연구소) ;
  • 고혜진 (건강보험심사평가원 심사평가연구소) ;
  • 장원모 (서울대학교보라매병원 공공의학과) ;
  • 이진용 (건강보험심사평가원 심사평가연구소)
  • Eunji Yun (HIRA Research Institute, Health Insurance Review and Assessment Service) ;
  • Boryung Ahn (HIRA Research Institute, Health Insurance Review and Assessment Service) ;
  • Hey jin Ko (HIRA Research Institute, Health Insurance Review and Assessment Service) ;
  • Won Mo Jang (Department of Public Health and Community Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Jin Yong Lee (Public Healthcare Center, Seoul National University Hospital)
  • 투고 : 2023.03.10
  • 심사 : 2023.05.10
  • 발행 : 2023.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The government of the Republic of Korea funded more than \15 trillion to healthcare providers to counter COVID-19. This study was conducted to examine the perception of the government funding program; to analyze it; and to explore its future direction to better prepare for upcoming pandemics. Methods: In-Depth Interview (IDI) was carried out of 16 subjects including doctors, policymakers, and professors from 7th June to 13th July 2021. Results: Every participant agreed that the subsidy made a huge contribution to preventing providers from bankruptcy and to stopping a collapse of healthcare system during the pandemic. However, different views occurred in the range of reimbursement. Providers recognized that it should have covered opportunity costs, extra expenses, and financial damage during the pandemic recovery. Whereas, the government perceived that the COVID-19 grant was enough to offset their financial damages. For future responses, most participants admitted that the program should be enhanced to be highly responsive to future pandemics. The standard of reimbursement needs to be eased to raise the funding rates; to reimburse more hospitals; and increase the compensation period and range. Conclusion: A pandemic like COVID-19 is highly likely to emerge more often forward. In a better response to future pandemics, it's required to level up disaster response capability; to keep healthcare services well-functioning during the emergency; and restructure healthcare system to be resilient even after the pandemic. To this end, an increase in subsidies should be positively reviewed.

키워드

참고문헌

  1. Yun E, Ko HJ, Ahn B, Lee H, Jang WM, Lee JY. Expanding medical surge capacity to counteract COVID-19: South Korea's medical fee adjustment through the national health insurance system. Risk Manag Healthc Policy. 2022;15:2031-42.  https://doi.org/10.2147/RMHP.S375422
  2. Joo YS. The reality and challenges of public health care shown by COVID-19. Health and welfare policy forum. 2022;1(9):2-4. 
  3. Park JH, Lee JC, Kim KH. Financial loss of medical clinics resulted from the COVID-19 outbreak in Korea. Journal of the Korean Medical Association. 2020;63(12):798-805.  https://doi.org/10.5124/jkma.2020.63.12.798
  4. Waitzberg R, Gerkens S, Dimova A, Bryndova L, Vrangbaek K, Jervelund SS, et al. Balancing financial incentives during COVID-19: A comparison of provider payment adjustments across 20 countries. Health Policy. 2022;126(5):398-407.  https://doi.org/10.1016/j.healthpol.2021.09.015
  5. Ministry of Health and Welfare. Payment of KRW 347.9 billion in loss compensation in January 2022 [Internet]. Sejong, Korea: Ministry of Health and Welfare; 2023 [cited 2023 Jan 13] Available from: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=369935. 
  6. Ministry of Health and Welfare. Current status of the national health insurance medical fee introduced by the Korean government in response to COVID-19. Sejong, Korea: Ministry of Health and Welfare; 2021. 
  7. Ministry of Health and Welfare. press release. Promotion of phased adjustment of designated hospital beds for COVID-19 [Internet]. Sejong, Korea: Ministry of Health and Welfare; 2023 [cited 2023 Feb 06] Available from: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=374742. 
  8. Medicaltimes. 1.46 trillion won invested in non-face-to-face treatment during the pandemic [Internet]. Seoul, Korea: Medicaltimes; 2023 [cited 2023 Feb 06] Available from: https://www.medicaltimes.com/Main/News/NewsView.html?ID=1148517. 
  9. Razu SR, Yasmin T, Arif TB, Islam MS, Islam SMS, Gesesew HA, et al. Challenges faced by healthcare professionals during the COVID-19 pandemic: A qualitative inquiry from Bangladesh. Front Public Health. 2021;9:2296-565.  https://doi.org/10.3389/fpubh.2021.647315
  10. Aslanyan L, Arakelyan Z, Atanyan A, Abrahamyan A, Karapetyan M, Sahakyan S. Primary healthcare providers challenged during the COVID-19 pandemic: a qualitative study. BMC Primary Care. 2022;23(1):2731-4553.  https://doi.org/10.1186/s12875-022-01923-4
  11. Qian Liu, Dan Luo, Joan E Haase, Qiaohong Guo, Xiao Qin Wang, Shuo Liu, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. The Lancet Global Health. 2020;8(6):790-8.  https://doi.org/10.1016/S2214-109X(20)30204-7
  12. Wanat M, Hoste M, Gobat N, Anastasaki M, Bohmer F, Chlabicz S, et al. Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries. The British journal of general practice. 2021;71(709):634-42.  https://doi.org/10.3399/BJGP.2020.1112
  13. OECD Policy Responses to Coronavirus (COVID-19). First lessons from government evaluations of COVID-19 responses: A synthesis. Paris, France: OECD; 2021. 
  14. Boyce C, Neale P. Conducting in-depth interviews: a guide for designing and conducting in-depth interviews for evaluation input. Pathfinder International; 2006. 
  15. Joffe H. Thematic analysis. Qualitative research methods in mental health and psychotherapy: a guide for students and practitioners. 2012:210-23. 
  16. Peel Karen L. A beginner's guide to applied educational research using thematic analysis. Practical Assessment, Research, and Evaluation. 2020;25(2):1-15. 
  17. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101.  https://doi.org/10.1191/1478088706qp063oa
  18. Michael QP. Qualitative research and evaluation methods. 4th Ed. 2002. California, USA: SAGE Press; 2002. 
  19. Medipana. COVID-19 frontline public hospital beds are still 'half cut'... Compensation for loss needs to be expanded [Internet]. Seoul, Korea: Medipana; 2023 [cited 2023 Jan 12] Available from: https://www.medipana.com/medician/view.php?page=6&sch_menu=2&sch_smenu=2001&sch_cate=A&news_idx=305058. 
  20. Medigatenews. Limitations of the 'Infectious Disease Prevention Act' revealed by COVID-19... Institutionalization of early clinical research and clarification of bedside compensation [Internet]. Seoul, Korea: Medigatenews; 2023 [cited 2023 Jan 12] Available from: https://m.medigatenews.com/news/1475056057. 
  21. Medigatenews. The government, COVID-19 loss compensation of 700 billion and loan support of 400 billion, etc., but... Helpless in the hospital's financial difficultie [Internet]. Seoul, Korea: Medigatenews; 2023 [cited 2023 Jan 13] Available from: https://m.medigatenews.com/news/2142303094. 
  22. Heo JW. Evaluation and implications of fiscal response to the economy during the COVID-19 crisis. Korea Development Institute Economic Outlook First half 2021; 2021. 
  23. Doctorsnews. Creating a 'quick' health insurance decision-making system, such as medical fees in case of disaster [Internet]. Seoul, Korea: Doctorsnews; 2023 [cited 2023 May 2]. Available from: https://www.doctorsnews.co.kr/news/articleView.html?idxno=143914. 
  24. Doctorsnews. Covid-19 loss compensation 'soon to be paid'..."Hospitals with large losses first" [Internet]. Seoul, Korea: Doctorsnews; 2023 [cited 2023 May 2]. Available from: https://www.doctorsnews.co.kr/news/articleView.html?idxno=134177. 
  25. European Observatory on Health Systems and Policies. COVID-19 health system response monitor. [Internet]. Brussels, Belgium: European Observatory on Health Systems and Policies; 2023 [cited 2023 Feb 25] Available from: https://eurohealthobservatory.who.int/monitors/hsrm/over-view. 
  26. American Medical Association. Summary of the paycheck protection program and health care enhancement act (COVID 3.5) [Internet]. Ilinois, USA: American Medical Association; 2023 [cited 2023 Mar 2]. Available from: https://www.ama-assn.org/delivering-care/public-health/summary-paycheck-protection-program-and-health-care-enhancement-act. 
  27. Eck WB, Kersey LE, Vafaeenia P. Update: Paycheck protection program and health care enhancement act increases funds available to hospitals and health care providers [Internet]. Washington DC, USA: Seyfarth; 2023 [cited 2023 Mar 2]. Available from: https://www.seyfarth.com/news-insights/update-paycheck-protection-program-and-health-care-enhancement-act-increases-funds-available-to-hospitals-and-health-care-providers.html. 
  28. European Observatory on Health Systems and Policies. COVID-19 health system response monitor. Germany Policy Responses [Internet]. Brussels, Belgium: European Observatory on Health Systems and Policies; 2023 [cited 2023 Feb 25]. Available from: https://eurohealthobservatory.who.int/monitors/hsrm/hsrm-countries/hsrm/germany/paying-for-services/health-financing. 
  29. Quentin W, Albreht T, Bezzina A, Bryndova L, Dimova A, Gerkens S, et al. Adjusting hospital inpatient payment systems for COVID-19. Eurohealth. 2020;26(2):88-92. 
  30. European Observatory on Health Systems and Policies. COVID-19 health system response monitor. Poland policy responses [Internet]. Brussels, Belgium: European Observatory on Health Systems and Policies; 2023 [cited 2023 Feb 25]. Available from: https://eurohealthobservatory.who.int/monitors/hsrm/hsrm-countries/hsrm/poland/paying-for-services/health-financing. 
  31. Thomas S, Sagan A, Larkin J, Cylus J, Figueras J, Karanikolos M. Strengthening health systems resilience - key concepts and strategies. Copenhagen, Denmark: European observatory on health systems and policies; 2020. 
  32. World Health Organization Regional Office for Europe. Strengthening and adjusting public health measures throughout the COVID-19 transition phases: policy considerations for the WHO European Region; Copenhagen, Denmark: WHO Regional Office for Europe; 2020. 
  33. European Observatory on Health Systems and Policies & World Health Organization. Regional Office for Europe. Managing health systems on a seesaw: balancing the delivery of essential health services whilst responding to COVID-19. Eurohealth. 2020;26(2):63-7. 
  34. Lee WJ. Chasing two hares with two hounds: a strategy for maintaining core functions of an acute care hospital amid COVID-19 crisis. Journal of the Korean Medical Association. 2021;64(2):152-8. https://doi.org/10.5124/jkma.2021.64.2.152