프랑스의 주치의 제도와 지역보건의료에 주는 정책적 시사점
France's Primary Care Physician System and Its Policy Implications for Korea's Healthcare and Community Health
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= Abstract = Objectives: France, despite having a strong practice of fee-for-service systems like Korea and well-guaranteed freedom for citizens to choose medical institutions, introduced the primary care physician system in 2004. By examining France's healthcare coverage and primary care physician system in detail, we will explore the necessary policy implications for Korea to establish primary care and community-based healthcare. Methods: This study employed a systematic search of websites and related materials from French government agencies and public health insurance systems concerning primary care, along with a review of relevant papers and literature. The analysis examines not only the existing fee-for-service model but also additional reforms like the capitation and performance-based payment within the primary care physician system. Results: France's primary care physician payment system remains fundamentally based on fee-for-service. Therefore, France is striving to increase the proportion of annual lump-sum payments and enhance the accessibility and quality of healthcare through performance-based payments. It is particularly supporting multidisciplinary group practices to play a central role in the primary care physician system. Furthermore, it has decided to continue piloting the group capitation payment system, which replaces fee-for-service with annual lump-sum payments. Conclusion: Over the past 20 years, France has developed its primary care physician system using the most incremental approach possible. Analyzing the primary care physician system France has experienced, and deriving policy implications for Korea's potential introduction of a primary care physician system, is extremely important.
Abstract
= Abstract = Objectives: France, despite having a strong practice of fee-for-service systems like Korea and well-guaranteed freedom for citizens to choose medical institutions, introduced the primary care physician system in 2004. By examining France's healthcare coverage and primary care physician system in detail, we will explore the necessary policy implications for Korea to establish primary care and community-based healthcare. Methods: This study employed a systematic search of websites and related materials from French government agencies and public health insurance systems concerning primary care, along with a review of relevant papers and literature. The analysis examines not only the existing fee-for-service model but also additional reforms like the capitation and performance-based payment within the primary care physician system. Results: France's primary care physician payment system remains fundamentally based on fee-for-service. Therefore, France is striving to increase the proportion of annual lump-sum payments and enhance the accessibility and quality of healthcare through performance-based payments. It is particularly supporting multidisciplinary group practices to play a central role in the primary care physician system. Furthermore, it has decided to continue piloting the group capitation payment system, which replaces fee-for-service with annual lump-sum payments. Conclusion: Over the past 20 years, France has developed its primary care physician system using the most incremental approach possible. Analyzing the primary care physician system France has experienced, and deriving policy implications for Korea's potential introduction of a primary care physician system, is extremely important.