Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
Institute of Health Services Research, Yonsei University, Seoul, Korea.
J Korean Med Sci. 2022 Oct 10;37(39):e284. doi: 10.3346/jkms.2022.37.e284.
The purpose of this study is to suggest priority tasks necessary for building a sustainable healthcare system in Korea based on the Delphi consensus among healthcare professionals.
Twenty-five items covering the three categories that make up healthcare policy (healthcare demand, supply, and environment) were selected based on a literature evaluation. Email surveys were also analyzed using a two-round modified Delphi method. Of 59 experts, 21 completed the first and second rounds. Each item asked about the degree of importance and urgency, and the answers were rated on a 9-point Likert scale. A coefficient of variation less than 50% for each item in the Delphi survey meant that consensus was reached. Only items that meet a predetermined threshold are prioritized (agreement ≥ 90%, average importance score and urgency score ≥ 6.5).
Eight items that satisfy all three criteria were set as priorities for a sustainable healthcare system. These tasks are "Securing the financial soundness of the National Health Insurance (NHI)," "Solving the problem of low fertility," "Strengthening response to public health crises such as infectious or environmental diseases," "Bio-health technology innovation using D.N.A (Data, Network, AI)," "Intensive management of dementia patients," "Mental healthcare and suicide prevention," "Reform of the operation structure of the NHI Service," and "Reform the healthcare delivery system and payment system."
The eight items for which consensus was reached in this study should be prioritized for Korea's sustainable healthcare system. Health policy makers will need to put considerable effort into researching and establishing these priorities.
本研究旨在通过医疗保健专业人员德尔菲共识,为韩国建立可持续医疗体系提出必要的优先任务。
根据文献评价,选择了涵盖医疗政策组成部分(医疗需求、供应和环境)的 25 个项目。还使用两轮改良 Delphi 法对电子邮件调查进行了分析。在 59 名专家中,有 21 名完成了第一轮和第二轮。每个项目都询问了重要性和紧迫性程度,答案在 9 点 Likert 量表上进行评分。德尔菲调查中每个项目的变异系数小于 50%表示达成共识。只有满足预定阈值的项目才会被优先考虑(协议≥90%,平均重要性得分和紧迫性得分≥6.5)。
满足所有三个标准的八项任务被确定为可持续医疗体系的优先事项。这些任务是“确保国家健康保险(NHI)的财务稳健性”、“解决低生育率问题”、“加强应对传染病或环境疾病等公共卫生危机的能力”、“利用 D.N.A(数据、网络、人工智能)进行生物健康技术创新”、“对痴呆症患者进行强化管理”、“心理健康保健和预防自杀”、“改革 NHI 服务的运营结构”和“改革医疗服务和支付系统”。
本研究达成共识的八项任务应优先考虑韩国的可持续医疗体系。卫生政策制定者需要投入相当大的精力来研究和确定这些优先事项。