Korean J Fam Pract.  2023 Jun;13(2):88-95. 10.21215/kjfp.2023.13.2.88.

Study on the Criteria for Priority-Setting and Application in Expanding Health Insurance Benefit of Preventive Medical Service: The Case of Obesity

• Ra G
• Lee S

• KMID: 2543190
• DOI: http://doi.org/10.21215/kjfp.2023.13.2.88

Abstract

Background
Under the increasing socioeconomic burden caused by rapid aging and chronic diseases, this study aimed to determine the priority criteria and evaluation indicators for preventive medical services focusing on obesity and propose a direction for benefits policies.
Methods
A two-round Delphi survey was conducted to select the priority criteria for determining benefits and their evaluation index. The survey interviewed 21 experts with research experience in turning preventive medical services into health insurance benefits and expanding coverage. The first survey was conducted from July 28 to August 6, while the second was conducted from August 11 to August 20 by email every seven days.
Results
When determining the benefit of preventive medical services as the priority criteria, experts listed the importance of treatment effectiveness, medical significance, and cost-effectiveness. The following people were prioritized as the beneficiaries of obesity preventive medical service: adults 18 years or older with a body mass index of 30 kg/m² or more. The survey respondents tended to agree that education counseling on nutrition and physical activity combined with behavioral and pharmacological treatment should prioritize health insurance benefits of obesity preventive medical service.
Conclusion
Focusing on the programs mentioned here, the intervention method of a multidisciplinary expert group centered on primary care, such as doctors, nurses, and nutritionists, should prioritize exercise prescriptions.

Keyword

Obesity; Preventive Medical Service; Health Insurance Benefit; Priority-Setting Criteria; Delphi Survey