Analytic Hierarchy Process를 이용한 건강보험 급여 우선순위 결정: 4대 중증질환 비급여항목을 중심으로

Background: Demands are recently rising for the securement of procedural justification of policy decision-making. This study aims to improve the procedure of making a decision to expand health insurance benefit package from the perspective of building a social consensus. Methods: Major priority principles were firstly derived through literature search. Weights for such principles were calculated through an analytic hierarchy process, based upon the survey conducted for the health policy experts. Priority for 11 non-covered services was assessed by applying the weights as above to the results of the questionnaire survey targeted at people including members of related committees or societies. Results: Weights for priority principles were in the order of ‘severity/urgency (0.428)’, ‘cost-effectiveness (0.318)’, ‘substitutability (0.164),’ and ‘accountability (0.090)’. What was obtained by applying these weights to the results of the questionnaire survey was considerably in line with what health experts classified those items into 3 groups depending on their own judgement of service necessity (consistent with 9 services out of 11). Conclusion: Results of the study are suggestive as to how far a brief assessment by experts could be utilized in case there are constraints on time and expenses in implementing all the process to secure procedural justification. Various attempts and endeavors need to be made to secure procedural justification that will not mar efficiency of decision-making in the days to come.