title: Defining the activities of publicness for Korea's public community hospitals using the Delphi method.
abstract: This study aims to identify which activities of a public community hospital (PHC) should be included in their definition of publicness and tries to achieve a consensus among experts using the Delphi method. We conduct 2 rounds of the Delphi process with 17 panel members using a developed draft of tentative activities for publicness including 5 main categories covering 27 items. The questions remain the same in both rounds and the applicability of each of the 27 items to publicness is measured on a 9-point scale. If the participants believe government funding is needed, we ask how much they think the government should support each item on a 0% to 100% scale. After conducting 2 rounds of the Delphi process, 22 out of the 27 items reached a consensus as activities defining the publicness of the PHCs. Among the 5 major categories, in category C, activities preventing market failure, all 10 items were considered activities of publicness. Nine of these were evaluated as items that should be compensated at 100% of total financial loss by the Korean government. Throughout results, we were able to define the activities of the PCH that encompassed its publicness and confirm that there are "good deficits" in the context of the PCHs. Thus, some PCH deficits are unavoidable and not wasted as these monies support a necessary role and function in providing public health. The Korean government should therefore consider taking actions such as exempting such "good deficits" or providing additional financial aid to reimburse the PHCs for "good deficits."
authors.affiliation: Department of Preventive Medicine, Konkuk University School of Medicine, Seoul Department of Nursing Science, Shinsung University, Dangjin Department of Public Health, the Graduate School of Public Health Institute of Health Policy and Management, Medical Research Center, Seoul National University Department of Health Policy and Management, Seoul National University College of Medicine, Seoul Department of Preventive Medicine, Chungnam National University School of Medicine, Daejeon Public Health Medical Service, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Kunsei
authors.initials: K
authors.lastname: Lee
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Myoungsoon
authors.initials: M
authors.lastname: You
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Sang Jun
authors.initials: SJ
authors.lastname: Eun
authors.forename: Hyoseon
authors.initials: H
authors.lastname: Jeong
authors.forename: Hye Mi
authors.initials: HM
authors.lastname: Ahn
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Lee
mesh_terms: D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration; D003697:Delphi Technique; D005380:Financing, Government / Q000191:economics / Q000458:organization & administration*; D017721:Hospital Costs / Q000458:organization & administration; D006764:Hospitals, Community / Q000191:economics / Q000458:organization & administration*; D006779:Hospitals, Public / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D056910:Republic of Korea; D017664:Uncompensated Care / Q000191:economics