의료서비스제도의 변화가 전문직의료인에게 미치는 영향

This study aims to understand the process how professional healthcare workers have adjusted to institutional changes caused by policy shifts in the public health insurance payment systems in Korea. Healthcare personnel inherently stick to their own professional expertise and tend to be resistant to abrupt institutional changes that may affect the way they treat their patients. Thus, conflicts often take place between the hospital management which has to enforce institutional changes and the healthcare professionals who resist adopting unfamiliar guidelines born out of new systems. This study examines the behavioral response of healthcare professionals facing the pressure from institutional change. Specifically, we attempt to investigate the contextual relationship between assimilation and appropriation. We conducted a cross sectional survey with 173 doctors and 413 nurses in 5 hospitals using a questionnaire developed to measure institutional pressure, resistance, assimilation, and appropriation.This paper demonstrates the influence of institutional change on organizations and individuals, and the process of structural change. We developed a new tool to measure appropriation in the process of institutional change in healthcare. The results of this paper provide direction and considerations for new institutional changes to be successfully applied. This study can help reduce cost and inefficiency of institutional changes.