J Korean Med Assoc.  2019 Apr;62(4):231-237. 10.5124/jkma.2019.62.4.231.

Essential health care

• Lee SM

• KMID: 2442740
• DOI: http://doi.org/10.5124/jkma.2019.62.4.231

Abstract

The term "essential health care" is used as both an absolute concept and a relative concept. In countries with a high level of economic development, the implications of the relative concept of essential health care are generally more important, as the essential medical services included within the absolute concept are usually covered. The definition of essential health technologies as those that should be prioritized in public healthcare from a socioeconomic point of view is crucial for the process of in a timely manner. These determinations should be based on scientifically rigorous, comprehensive, and critical evaluations, including systematic reviews of the literature, and decision-making should proceed through a process of based on medical and socio-economic values. These decision-making processes should be transparent and consistent. In South Korea, the legal standard for decision-making by the health insurance program regarding whether mandates taking into account medical validity, medical, effectiveness, cost-effectiveness, patient cost burden, and social benefits. However, there are a number of committees that make coverage decisions, and there are no guidelines for standardized decision-making methods and procedures; therefore, it is urgently necessary to develop an explicit, detailed and specific decision-making guideline.

Keyword

Patient acceptance of health care; Needs assessment; Evidence-based practice; Health insurance

MeSH Terms

Delivery of Health Care*
Economic Development
Evidence-Based Practice
Humans
Insurance, Health
Korea
Needs Assessment
Patient Acceptance of Health Care

Figure

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  Figure 1 Universal health coverage and essential health care services. Adapted from Boerma T et al. Monitoring progress towards universal health coverage at country and global levels: framework, measures and targets. Geneva: World Health Organization; 2014 [4].

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  Figure 2 Schematic figure of concept for relatively and absolutely essential healthcare.

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  Figure 3 Decision framework for the coverage of new health technologies in the national health insurance. OOP, out of pocket; CED, coverage with evidence development. Adapted from Yun YJ, et al. Evid Value Healthcare 2017;3:78-83 [13].

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