Abstract
Korea has achieved a remarkable expansion in health coverage at modest costs relative to other Organization for Economic Cooperation and Development (OECD) countries. Hospitals are more accessible and equipped with more advanced medical technologies than in most other OECD countries. OECD Reviews of Health Care Quality seek to support the development of better policies to improve the quality of healthcare. In 2012, a report on Korea presented best practices and offered recommendations for improvement in the Korean health system. Korea's health care system needs to shift its focus from simply supporting an ever-continuing expansion of acute care services to quality of healthcare. First, Korea needs to strengthen the focus of governance to the quality of healthcare by establishing HIRA as an institutional champion for quality. Second, Korea must strengthen primary healthcare because in Korea it is woefully underdeveloped today. Third, Korea must use financing to drive improvements in quality of care. In reality, HIRA has used its power over healthcare providers to force them to accept financial constraints; it has not supported quality of all healthcare sectors. Without structural changes allowing for independent judgment on the quality at HIRA, NECA is more suitable for ensuring quality for all healthcare sectors. As suggested by the OECD report, Korea must strengthen primary healthcare by restoring patients' trust in health professionals. In using financing to drive improvements in quality of healthcare, Pay for Performance may be helpful, but that must be driven on a voluntary basis and with a great financial incentive.
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