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KMID : 0387320130230040326
Korean Journal of Health Policy and Administration
2013 Volume.23 No. 4 p.326 ~ p.342
Policy Elites¡¯ Perception of Health Policy Governance: Findings from In-depth Interviews of Korean New Diagnosis Related Group Paym
Shon Chang-Woo

Kwon Soon-Man
You Myoung-Soon
Abstract
Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of ¡¯governing health policy¡¯-the ways health care policy is made, implemented, and evaluated from a political perspective.

Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews.

Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms.

Conclusion: This study implied the importance of social consensus and the governance of health policy.
KEYWORD
Governance, In-depth interview, New Diagnosis Related Group, Diagnosis Related Group, Prospective payment system
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