Expansion of Severe Cases to 70% in Tertiary Hospitals... 15% Reduction in General Beds

Preventing Patient Concentration at Tertiary Hospitals by Strengthening Secondary Hospitals
Annual 200 Billion KRW Investment in Regional National University Hospitals
Referral System for Transfer of Patients Based on Severity

The government will implement the 'Tertiary General Hospital Structural Transformation Support Project' starting next month to establish a sustainable treatment system focused on severe and emergency cases and to establish a desirable medical delivery system. Accordingly, tertiary general hospitals must increase the proportion of severe patients to 70% within three years while reducing general beds by up to 15%.

On the 30th, the government held the 6th Medical Reform Special Committee meeting at the Government Seoul Office to discuss the plan for the tertiary general hospital structural transformation support project.

Noh Yeon-hong, Chairman of the Special Committee on Medical Reform, is speaking at the meeting of the Special Committee on Medical Reform held on the 30th at the Government Seoul Office in Jongno-gu, Seoul. Photo by Jo Yong-jun jun21@

Tertiary General Hospitals Focused on Severe Care

First, to strengthen the function of tertiary general hospitals as severe or tertiary medical institutions, the tertiary general hospital support project will be implemented. Although tertiary general hospitals are comprehensive hospitals specializing in high-difficulty medical procedures for severe diseases, they have been criticized for performing functions inconsistent with their role by handling a significant portion of mild and moderate patient care.

Accordingly, tertiary general hospitals participating in the support project must increase the proportion of severe patients to 70% within three years or raise it by more than 50% from the current proportion. In Seoul, hospitals with a total licensed bed count of 1,500 or more must reduce general beds by 15%, while other tertiary general hospitals in Seoul must reduce general beds by 10%.

Tertiary general hospitals in the metropolitan area must reduce general beds by 10%, and those outside the metropolitan area by 5%. However, general beds in pediatric public specialized treatment centers, emergency centers, and trauma centers are excluded from the reduction targets.

To enable a stable transition focused on severe patients, fees for severe patient care will be increased and performance rewards supported. Hospitalization fees and intensive care unit fees will be increased by a fixed amount of about 50%, and fees for severe surgeries and anesthesia procedures will also be raised.

For tertiary general hospitals outside the metropolitan area, specialist professional care and referral/transfer compensation within the region will be strengthened. In particular, to enhance the emergency medical function of tertiary general hospitals, on-duty and standby compensation for 24-hour emergency care will be newly established for the first time.

Strengthening Secondary Hospitals to Alleviate Concentration in Tertiary Hospitals

To prevent concentration in tertiary general hospitals, the capacity of secondary hospitals will also be strengthened. The government plans to strengthen the core functions of general hospitals, such as 'comprehensive treatment capacity' and severe emergency functions like heart and brain care, and to enhance target compensation for general hospitals with excellent functions and performance.

Additionally, to foster specialized hospitals providing essential specialized care such as cardiac, brain, digit replantation, and burn treatment, a 'Comprehensive Reform Plan for Designation and Fostering of Specialized Hospitals' will be announced next year, and appropriate compensation will be provided to specialized hospitals.

An subacute medical system for recovery and rehabilitation will also be established. Follow-up tasks will include development plans covering ▲subacute hospital functions ▲types ▲horizontal medical system construction between acute and subacute care ▲and appropriate compensation systems.

The capacity of regional base hospitals will be dramatically increased so that local patients can receive treatment without traveling to Seoul. To this end, 183.6 billion KRW will be invested in modernizing facilities and equipment, including operating rooms and intensive care units at national university hospitals, strengthening financial investment.

From next year, 200 billion KRW annually will be intensively invested in regional national university hospitals, and regulations such as 'total personnel expenses' and 'total staff quotas,' which have been identified as obstacles to essential medical investment at national university hospitals, will be abolished. Starting with an increase of 330 professor positions at regional national university hospitals next year, the number will be expanded to 1,000 by 2027. Additionally, 11 billion KRW will be newly invested in specialized research and development (R&D) at regional national university hospitals to enhance clinical, educational, and research capabilities.

Alongside this, to expand the regional medical workforce, a 'Contract-type Essential Physician System' will be introduced targeting specialists. Starting next year, monthly regional work allowances of 4 million KRW will be provided to 96 specialists in eight departments?internal medicine, surgery, obstetrics and gynecology, pediatrics, emergency medicine, thoracic surgery, neurology, and neurosurgery?in four regions.

Economic and non-economic support measures will also be prepared to encourage specialists who graduate from regional medical schools and complete residency training at regional hospitals to settle in the region.

'Specialist Referral System' Where Doctors Directly Book Hospital Appointments

To ensure medical use appropriate to patient diseases and severity, a 'specialist referral system' will be established, and the cost structure will be reformed so that mild patients use local clinics and hospitals rather than large hospitals.

To prevent patients from arbitrarily visiting large metropolitan hospitals with referral letters, a 'specialist referral system' will be introduced, requiring medical judgment to guide patients to appropriate medical institutions. Doctors will directly book appointments at appropriate local medical institutions based on communication with patients, and in such cases, a 'fast-track' system will be established to ensure that these patients receive priority care. Fee compensation and usage incentives will also be strengthened to encourage both medical consumers and providers to use the specialist referral system.

It will also be clarified that when patients decide in advance which hospital to visit and request doctors to write referral letters, doctors refusing to write them or transferring patients to other hospitals because they are not severe cases treatable at the referred institution will not be considered refusal of care.

The number of representative mild outpatient diseases for which using local clinics is recommended will be expanded from the current 105. Mild patients using tertiary general hospitals must bear the full cost of treatment, but if they use clinics, they only pay 30% of the cost.

To improve convenience for chronic and mild patients, telemedicine currently being piloted will be institutionalized.

Additionally, for mild and non-emergency patients classified as levels 4?5 in the Korean Triage and Acuity Scale (KTAS), outpatient co-payments will be increased when using regional and local emergency medical centers, and the number of local medical institutions and fever clinics available to mild emergency patients will be expanded.

To encourage mild patients to use local clinics rather than tertiary general hospitals, outpatient fees will be increased from the current 60% co-payment to full self-payment unless there is a secondary hospital referral letter or exceptional reasons such as special diagnosis cases.

This content was produced with the assistance of AI translation services.