Health Policy Manag.  2021 Sep;31(3):280-291. 10.4332/KJHPA.2021.31.3.280.

The Publicness of Public Institutions: Case Study on the Korea Medical Dispute Mediation and Arbitration Agency

• Yang F

• KMID: 2525752
• DOI: http://doi.org/10.4332/KJHPA.2021.31.3.280

Abstract

Background
Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications.
Methods
Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present.
Results
As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders’ perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens’ use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized.
Conclusion
While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.

Keyword

Medical dispute; Medical dispute mediation and arbitration agency; Moore’s strategic triangle; Public value; Publicness