Journal of the Korean Medical Association (대한의사협회지)

Korean Medical Association (대한의사협회)
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Payment reform for the improvement of primary care in Korea

일차의료 강화를 위한 지불제도 개편방안

  • Jeong, Hyunjin (Institute for Health Insurance Policy Research, National Health Insurance Corporation) ;
  • Lee, Heeyoung (Gachon University Gil Medical Center) ;
  • Lee, Jae-Ho (Department of Family Medicine, Catholic University College of Medicine) ;
  • Lee, Taejin (Graduate School of Public Health, Seoul National University)
  • 정현진 (국민건강보험공단 건강보험정책연구원) ;
  • 이희영 (가천대학교 길병원) ;
  • 이재호 (가톨릭대학교 의과대학 가정의학과) ;
  • 이태진 (서울대학교 보건대학원)
  • Received : 2013.09.05
  • Accepted : 2013.09.19
  • Published : 2013.10.01
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Abstract

Strengthening primary care has always been a major policy issue in most developed countries to achieve the health care system's goals, and policy makers continuously try to use payment system as an effective tool to improve overall performance of primary care. In this paper, we examined the various payment methods and growing trends in primary care payment system in some developed countries. Overall, a common form of payment for primary care doctors is a blend of fee-for-service (FFS), capitation, and pay-for-performance (P4P). In addition, many countries are still in the way of many new trials to find the right way to provide primary care service effectively, to meet the complex health care needs of populations. In Korea, primary care system is not well-established, and other institutional arrangements are not in good conditions for primary care, either. FFS, which is a dominant payment method in Korea, is not favorable for achieving good attributes of primary care. Mixing various payment components, like capitation, P4P to current FFS is essential to provide the optimal incentive structures for primary care physicians. Also, new models to encourage doctor-patient relationships with appropriate P4P mechanisms could be used as an early step in reforming primary care payment system gradually.

Keywords

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