보건의료 정책결정과정에서 환자 및 시민참여 연구: 영국 신노동당정부의 국영의료체계 내에서 환자 및 시민참여 사례들을 중심으로

초록

This study explored the experiences of the public and patient involvement(PPI) in the NHS under the Labor government(1998-2009). From the outset, the Labor government had applied actively the PPI policy to all NHS organizations. Though there was a little backdrop due to the reinforcement of the marketization of the NHS after the midpoint of the lifetime of the labor government, these policy has maintained continuously without a break. Three PPI programs were analyzed on the points that their process met four criteria for effective participation process and influenced the outcome of a decision-making. Local Involve Networks was built up to reflect patient and public views on a decision making process of Primary Care Trust and Local Authority. It had access to information, official route for delivering public view to decision maker, educational and technical support for participants despite of there being a lack of representation. Citizen and patient governors, who are members of the board of governors for NHS foundation trust, had somewhat representation due to being elected by members, while they had little influence on the board of directors as well as insufficiency of the other three criteria for effective participation process. Two lay people among patients or carers concerned with target disease of clinical guidelines were involved in the guildeline development and also patient organization related to the disease could work as a stakeholder in the condition that the patient organziation had members nationally. These program met sufficiently four criteria for the effective participation process and also showed a visible impact on clinical guideline even though it was concentrated on non medical part such as family education. These experiences in the NHS may be very available for making judgement over introuducing PPI policy, designing a effective participation process, and predicting what that policy will bring to us.

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