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http://dx.doi.org/10.4332/KJHPA.2010.20.2.053

Improving Priority-setting procedures for NHI benefit package  

Yun, Hee-Suk (Korea Development Institute)
Kwon, Soon-Man (Seoul National University)
Kwon, Yong-Jin (Seoul National University)
Publication Information
Health Policy and Management / v.20, no.2, 2010 , pp. 53-68 More about this Journal
Abstract
In health care, the process of resource allocation becomes a controversial process of rationing, as scarce resources are allocated between the numerous health care interventions. Especially for the last few years, decisions to define and expand the benefit package of National Health Insurance have always become the object of fierce criticism. It is partly because we have not reached a collective agreement as to what the most important criteria for spending priorities are. This paper considers the procedures and the principles which could be used to determine rationing in health care, and emphasizes the need to have explicit principles which determine patient access to care and to have an evidence base to inform rationing decisions. Also, the need to set up a public committee is suggested to take rationing decisions on behalf of government and NHS and to present them as evidence-based decisions.
Keywords
NHI Benefit Package; Priority-setting procedure and principle; fair deliberative process;
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  • Reference
1 Daniels N. Just Health : Meeting Health Needs Fairly. Cambridge University Press ; 2008.
2 Dolan P, Shaw R, Tsuchiya A, Willams A. QALY maximization and people's preference : A methodological review of the literature. Health Economics 2005;14(2) : 197-208.   DOI   ScienceOn
3 Hunter D J. The practice of rationing health care in the United Kingdom. In : Breyer F et al.(eds.) Rationing medicine. Berlin : Springer ; 2002.
4 Jordon J, Dowswell T, Harrison S, Lilford R J, Mort M. Health needs assessment. Whose priorities? Listening to users and the public. BMJ 1998 ; 316(7145) : 1668-70.   DOI   ScienceOn
5 Lenaghan J. Involving the public in rationing decisions : The experience of citizens juries. Health Policy 1999 ; 49(1-2):45-61.   DOI   ScienceOn
6 Maynard A, Bloor K. Our certain fate : rationing in health care. London : Office of Health Economics ; 1998.
7 OECD. OECD Heath Data 2009. 2009.11.9. Available from: URL: http : // www.sourceoecd.org
8 Rawls J. Justice as Fairness : A Restatement. Harvard University Press ; 2001.
9 Tobin J. On Limiting the Domain of Inequality. Journal of Law and Economics 1970 ; 13(2) : 263-277.   DOI   ScienceOn
10 조정숙. 보험급여 확대 항목 선정을 위한 우선 순위 설정 : AHP기법 적용[석사학위논문]. 서울 : 연세대학교 대학원 ; 2005. 12.
11 허순임, 신호성, 강민아, 김태일, 김창보. 건강보험 적정 보장성 확보방안. 한국보건사회연구원. 2007.
12 국민건강보험공단. 보장성 강화 TF 활동 보고서. 2006a.
13 국민건강보험공단. 독일출장보고서 - 수가계약을 중심으로. 2006b.
14 권순만. 건강보험 보장성 수준 및 달성 전략. 서울대학교 보건대학원. 2007.
15 김정희, 이호용, 정현진. 2007년 건강보험환자의 본인부담 진료비 실태조사. 국민건강보험공단 건강보험연구원. 2008.
16 양봉민, 김진현, 이태진, 김윤희, 김정희, 최숙자. 건강보험의 목표보장률 설정 및 실현방안에 관한 연구. 서울대학교 보건대학원. 2006.
17 김용익, 이평수, 조홍준, 김창엽, 김선민, 김윤 등. 건강보험 재정설계 연구. 국민의료보험관리공단․서울대학교 의과대학. 2000.
18 박종연, 한만호, 김재연, 서남규. 건강보험제도 발전을 위한 국민 인식도 조사연구. 국민건강보 험공단 건강보험연구센터 2003.
19 보건복지가족부. 건강보험 암 및 치과분야의 보장성 확대 추진. 보도자료. 2009. 6. 17.
20 정형선, 이규식, 신의철, 김주경, 최원숙, 백재현 등. 국민건강보험 내실화를 위한 기본급여영역 에 관한 연구. 국민건강보험공단.연세대학교보건행정학과. 2004.