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OECD Reviews of Health Care Quality: Korea 2012

Raising Standards

image of OECD Reviews of Health Care Quality: Korea 2012

At a time when ever more information is available about the quality of health care, the challenge for policy makers is to better understand the policies and approaches that sit behind the numbers. Korea is the first country report in a new OECD series evaluating the quality of health care across OECD countries – whether care is safe, effective and responsive to patients’ needs. OECD Reviews of Health Care Quality examine what works and what does not work, both to benchmark the efforts of countries and to provide advice on reforms to improve quality of health care. This series of individual country reviews will be followed by a final summary report on the lessons learnt for good policy practices.

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Using financing to drive improvements in health care quality

This chapter examines the financing and organisation of the Korean health care system and whether it is driving improvements in the quality of care. Korea’s national health insurance faces a difficult budgetary environment as it grapples with rapidly rising health care costs, in large part driven by a very competitive hospital sector that is underpinned by fee-for-service financing rewarding the over-supply of medical services. It is argued that Korea ought to use its single insurer to more explicitly drive quality across the health care system. This should begin by shifting to financing hospitals through diagnostic-related groups (DRGs) to reduce the over-provision of services per patient. More broadly, stronger budgetary controls on hospital expenditure should be used to shift the balance of funding towards primary care over time. In this context, Korea’s unique pay for performance programme has demonstrated the capacity to extract valuable information to assess the quality of care. Future reform should seek to build on this by incorporating assessments of quality of care into financing.

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