Health Policy Manag.  2020 Sep;30(3):286-300. 10.4332/KJHPA.2020.30.3.286.

A Study on the Policy Decision Making Process of Seoul-Type Paid Sick Leave: Applying Kingdon’s Multiple Streams Model

  • 1Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
  • 2Department of Health and Care Administration, The Cyber University of Korea, Seoul, Korea
  • 3Department of Health and Policy Management, College of Health Science, Korea University, Seoul, Korea


In 2019, the Seoul metropolitan government established its own ‘Seoul-type paid sick leave project’. Although the central government had to introduce such a system, which is also called sickness benefits, it was not implemented. In order to understand the process by which the Seoul government has implemented such a policy, this study used Kingdon’s multiple streams framework. As a result, in the problem stream, it was found that the economic burden of sickness has been considered only in terms of medical expenses in the past of Korea. Then Songpa’s three women and Middle East respiratory syndrome incidents raised awareness of the necessity of the sickness benefit system in 2014 and 2015. In the political stream, several social affairs such as national health insurance huge surpluses and the 2017 presidential election opened policy window. At that time, Seoul Mayor actively promoted sickness benefits as a policy entrepreneur. In the policy stream, the sickness benefit system has gained new attention through political events. To summary, these three streams flowed separately and then they assembled around huge political affairs. As a result, it was confirmed that Kingdon’s model is the most effective theory than any other models in analyzing the health care policy decision process in Korea.


Sickness benefit; Paid sick leave; Multiple streams framework; Policy decision making model
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