Health Policy Manag.  2018 Sep;28(3):197-201. 10.4332/KJHPA.2018.28.3.197.

An Organization Theory Perspective on the Structural Reform of the Health Care Delivery System

• Han DS

• KMID: 2422524
• DOI: http://doi.org/10.4332/KJHPA.2018.28.3.197

Abstract

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

Keyword

Health care delivery system; Organizational form of medical care institutions; Environment of medical care institutions; Relationships between medical care providers

MeSH Terms

Consensus
Delivery of Health Care*
Humans
Korea
Primary Health Care
Tertiary Healthcare