• 제목/요약/키워드: Health care rationing

검색결과 4건 처리시간 0.017초

건강보험보장성 정책결정과정의 평가와 재설계 (Improving Priority-setting procedures for NHI benefit package)

  • 윤희숙;권순만;권용진
    • 보건행정학회지
    • /
    • 제20권2호
    • /
    • pp.53-68
    • /
    • 2010
  • 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.

Public Preferences for Allocation Principles for Scarce Medical Resources in the COVID-19 Pandemic in Korea: Comparisons With Ethicists' Recommendations

  • Lee, Ji-Su;Kim, Soyun;Do, Young Kyung
    • Journal of Preventive Medicine and Public Health
    • /
    • 제54권5호
    • /
    • pp.360-369
    • /
    • 2021
  • Objectives: The purpose of this study was to investigate public preferences regarding allocation principles for scarce medical resources in the coronavirus disease 2019 (COVID-19) pandemic, particularly in comparison with the recommendations of ethicists. Methods: An online survey was conducted with a nationally representative sample of 1509 adults residing in Korea, from November 2 to 5, 2020. The degree of agreement with resource allocation principles in the context of the medical resource constraints precipitated by the COVID-19 pandemic was examined. The results were then compared with ethicists' recommendations. We also examined whether the perceived severity of COVID-19 explained differences in individual preferences, and by doing so, whether perceived severity helps explain discrepancies between public preferences and ethicists' recommendations. Results: Overall, the public of Korea agreed strongly with the principles of "save the most lives," "Koreans first," and "sickest first," but less with "random selection," in contrast to the recommendations of ethicists. "Save the most lives" was given the highest priority by both the public and ethicists. Higher perceived severity of the pandemic was associated with a greater likelihood of agreeing with allocation principles based on utilitarianism, as well as those promoting and rewarding social usefulness, in line with the opinions of expert ethicists. Conclusions: The general public of Korea preferred rationing scarce medical resources in the COVID-19 pandemic predominantly based on utilitarianism, identity and prioritarianism, rather than egalitarianism. Further research is needed to explore the reasons for discrepancies between public preferences and ethicists' recommendations.

2011~2015년 신규간호사와 경력간호사의 이동 경향과 지역 간 이동의 영향 요인 (Patterns and Influential Factors of Inter-Regional Migration of New and Experienced Nurses in 2011~2015)

  • 박보현;김세영
    • 대한간호학회지
    • /
    • 제47권5호
    • /
    • pp.676-688
    • /
    • 2017
  • Purpose: The purpose of this study was to analyze the migration patterns of new nurses and experienced nurses and to identify the factors influencing inter-regional migration for solving regional imbalances of clinical nurses in South Korea. Methods: This study involved a secondary analysis of data from the Health Insurance Review and Assessment Service (HIRA). Data were analyzed using descriptive statistics and multiple logistic regression analysis. Results: New nurses tended to migrate from Kyunggi to Seoul. However, experienced nurses tended to migrate from Seoul and Chungchung to Kyunggi. Significant predictors of inter-regional migration among new nurses were location and nurse staffing grade of hospitals. Significant predictors of inter-regional migration among experienced nurses were location, hospital type, nurse staffing grade, ownership of hospitals and age of nurses. Conclusion: Inter-regional migration occupied a small portion of total hospital movement among clinical nurses. The regional imbalances of nurses were not caused by the migration from non-metropolitan areas to Seoul. Nurse shortage problems in the small and medium hospitals of the non-metropolitan area can be solved only through improvement of work environment.