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Saturday, 5 October 2019

Taraf Kesihatan Korea Selatan



Healthcare in South Korea

 

 
 


South Koreans have the right to universal healthcare, ranking first in the OECD for healthcare access.[1] Satisfaction of healthcare has been consistently among the highest in the world – South Korea was rated as the fourth most efficient healthcare system by Bloomberg.[2][3]

The quality of South Korean healthcare has been ranked as being among the world's best. It had the OECD's highest colorectal cancer survival rate at 72.8%, significantly ahead of Denmark's 55.5% or the UK's 54.5%. It ranked second in cervical cancer survival rate at 76.8%, significantly ahead of Germany's 64.5% or the U.S. at 62.2%.[4] Hemorrhagic stroke 30 day in-hospital mortality per 100 hospital discharges was the OECD's third lowest at 13.7 deaths, which was almost twice as low as the U.S. at 22.3 or France's 24 deaths. For Ischemic stroke, it ranked second at 3.4 deaths, which was almost a third of Australia's 9.4 or Canada's 9.7 deaths. South Korean hospitals ranked 4th for MRI units per capita and 6th for CT scanners per capita in the OECD. It also had the OECD's second largest number of hospital beds per 1000 people at 9.56 beds, which was over triple that of Sweden's 2.71, Canada's 2.75, the UK's 2.95, or the U.S. at 3.05 beds.[5]

Social health insurance was introduced with the 1977 National Health Insurance Act, which provided industrial workers in large corporations with health insurance.[6] The program was expanded in 1979 to include other workers, such as government employees and private teachers. This program was thereafter progressively rolled out to the general public, finally achieving universal coverage in 1989.[7] Despite being able to achieve universal health care, this program resulted in more equity issues within society as it grouped people into different categories based on demographic factors like geographical location and employment type.[8] These different groups ultimately received different coverage from their respective healthcare providers.

The healthcare system was initially reliant on not-for-profit insurance societies to manage and provide the health insurance coverage. As the program expanded from 1977 to 1989, the government decided to allow different insurance societies to provide coverage for different sections of the population in order to minimize government intervention in the health insurance system. This eventually produced a very inefficient system, which resulted in more than 350 different health insurance societies.[9] A major healthcare financing reform in 2000 merged all medical societies into the National Health Insurance Service.[10] This new service became a single-payer healthcare system in 2004. The four-year delay occurred because of disagreements in the legislature on how to properly assess self-employed individuals in order to determine their contribution.[6]

The insurance system is funded by contributions, government subsidies, and tobacco surcharges and the National Health Insurance Corporation is the main supervising institution. Employed contributors are expected to pay 5.08% of their income while self-employed contributions are calculated based on the income and property of the individual. The national government provides 14% of the total amount of funding and the tobacco surcharges account for 6% of the funding.[11] The total expenditure on health insurance as a percentage of gross domestic product has increased from 4.0% in 2000 to 7.1% in 2014.[12] In 2014, total health expenditure per capita was $2,531, compared to a global average of $1058, and government expenditure on health per capita was $1368.[13]

The number of hospital beds per 1000 population is 10, well above the OECD countries' average of 5.[14] According to Mark Britnell hospitals dominate the health system. 94% of hospitals (88% of beds) are privately owned. 30 of the 43 tertiary hospitals are run by private universities. 10 more are run by publicly owned universities. Payment is made on a fee-for-service basis. There is no direct government subsidy for hospitals. This encourages hospitals to expand and discourages community services.[15]

The Korea International Medical Association has been formed to encourage medical tourism. Nearly 400,000 medical tourists visited South Korea in 2013 and that number is projected to rise to 1 million by 2020.[16] Compared to procedures done in the US, patients can save between 30 and 85% if they have the treatment in South Korea.[17][18] It has been reported that some Korean hospitals charge foreign patients more than local patients due to customized service such as translation and airport pickup. As a result, some medical tourists have complained that this is unfair[19][20]


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