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공공병원 직원들의 신포괄수가제 참여 전후 인식변화

Changes in Public Hospital Employees' Perceptions Following the Introduction of the New Diagnosis-Related Groups (DRG)-Based Payment System in the Republic of Korea

  • 김현주 (신성대학교 간호학과) ;
  • 이진용 (서울대학교병원 공공진료센터)
  • Kim, Hyun Joo (Department of Nursing Science, Shinsung University) ;
  • Lee, Jin Yong (Public Healthcare Center, Seoul National University Hospital)
  • 투고 : 2021.08.18
  • 심사 : 2021.11.11
  • 발행 : 2021.12.31

초록

Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.

키워드

과제정보

This research was supported by a clinical research grant-in-aid from the Seoul Metropolitan Government-Seoul National University Boramae Medical Center (04-2019-04).

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