제도적 관점에서 본 공유의사결정에 대한 탐색적 고찰: 주요 국가의 선행 경험이 한국에 주는 시사점을 중심으로

• Published in: 의료커뮤니케이션 Vol. 19; no. 2; pp. 7 - 18
• Main Authors: 윤현옥, Hyunok Yun, 우경숙, Kyung-sook Woo, 이도영, Do-young Lee, 유상호, Sang-ho Yoo
• Format: Journal Article
• Language: Korean
• Published: 대한의료커뮤니케이션학회 30.12.2024
• Subjects: Health policy; Patient participation; Patient-centered healthcare; Shared decision making; 공유의사결정; 보건정책; 의학일반; 환자중심의료; 환자참여
• ISSN: 1975-888X; 2713-6825
• DOI: 10.15715/kjhcom.2024.19.2.7

Purpose : As the healthcare paradigm shifts towards a patient-centered approach, shared decision-making (SDM) is gaining importance. SDM involves selecting treatment options through expert information provided by healthcare professionals and active patient engagement. This study examines international cases of SDM implementation to derive insights for establishing a system suitable for the domestic healthcare environment. Methods : We selected four countries-the United States, the United Kingdom, Germany, and the Netherlands-that have adopted SDM as a key element of patient-centered care. These countries are conducting government-led pilot programs or integrating SDM into healthcare coverage through insurance benefits. Our analysis is based on a review of laws, policy reports, research publications, and academic literature. Results : The United States, through the Centers for Medicare & Medicaid Services (CMS), has piloted SDM in Medicare and hospices and is expanding policies to include SDM within insurance coverage for certain hospital departments. The United Kingdom’s National Health Service (NHS) incorporates SDM into chronic disease management programs, with plans to extend it to primary and community care. Germany has successfully piloted various SDM models and educational programs and is integrating SDM into routine care. In the Netherlands, the government is actively funding a range of SDM-related projects, from the development of SDM tools to performance evaluations, playing a crucial role in promoting SDM in hospitals. Conclusion : Key factors for the successful adoption of SDM include strong government support, stakeholder collaboration, a robust legal framework, standardized guidelines, and appropriate payment systems for healthcare providers.