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Financial state of primary care physicians under the Korean insurance system

Article information

J Korean Med Assoc. 2011;54(1):98-111
Publication date (electronic) : 2011 January 15
doi : https://doi.org/10.5124/jkma.2011.54.1.98
Geum Ja Im, PhD1, Hye Young Min, PhD1, Jin Woo Choi, CPA1, Sun Mi Lim, PhD1, Yoon Hyung Park, MD1,2
1Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea.
2Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Corresponding author: Yoon Hyung Park, parky@sch.ac.kr
Received 2010 December 13; Accepted 2010 December 27.

Abstract

Greater than its influence on the medical practitioner's individual ability is the National Health Insurance System's influence on the management of medical practitioners' offices in Korea. However, despite the important effect health insurance exerts on the income of medical clinics, recently, the financial difficulties of medical clinics have often become an issue, and financial difficulty has been aggravated as much as a solution has been sought. The current state of the overall management of medical clinics was investigated to understand the factors influencing the sales and expenses in their management. A questionnaire was completed by 1,009 physicians registered in the Korean Medical Association who were participating in a statistical extraction course. As a result of the study, the factors influencing the total revenue and total expenditures of medical clinics, such as increases in the total number of doctors, increasing numbers of outpatients, the size of the medical office, medical disputes, and clinical specialties (based on the first medical treatment) showed statistical significance. In conclusion, in order to improve medical clinic management, a health insurance medical fee should be more reasonably fixed, a medical transfer system should be reestablished, and a cooperative strategy should be created for medical clinics and general hospitals in order to attract patients. As a result, low cost and highly efficient medical services could be provided and the satisfaction of patients improved.

Keywords: National Health Insurance System; Health insurance medical fee; Medical practitioner's offices

References

1. National Health Insurance Corporation 2010. cited 2010 Nov 20. Seoul: National Health Insurance Corporation; Available from: http://www.nhic.or.kr.
2. Im GJ. Management analysis of clinics in 2003. Healthc Policy Forum 2003. 1158–165.
3. National Health Insurance Corporation 2005. cited 2010 Nov 20. Seoul: National Health Insurance Corporation; Available from: http://www.nhic.or.kr.
4. Oh CS. Status and vitalization plan of primary medical institutions. Healthc Policy Forum 2003. 166–183.

Article information Continued

Copyright © 2010 Korean Medical Association

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figure 1

Figure 1

Clinic operation performance from an investor's perspective (2008 fiscal year)

Figure 2

Figure 2

Reason for fee reduction.

Table 1

Distribution according to respondents' characteristics, clinic type per & clinical area of clinics

Table 1

a)Unlike other items, only 1,004 out of 1,009 answered the question on age.

Table 2

Clinic hours

Table 2

Table 3

Daily average number of outpatients per clinic or per doctor

Table 3

Values are presented as number (%).

Table 4

Percentage of clinics employing a graded fee system

Table 4

Table 5

Comparison analysis of 2008 sales per clinic (unit: KRW)

Table 5

KRW, Korean won; NHI, National Health Insurance; HIRA, Health Insurance Review & Assessment Service.

Table 6

Profit/Loss status of clinics for the 2008 fiscal year per subject

Table 6

KRW, Korean won.

Table 7

Comparison of fee reduction incidents per subject · open period · area

Table 7

Values are presented as number (%).

Table 8

Comparison of fee reduction amount per subject · open period · area

Table 8

Values are presented as number (%).

KRW, Korean won.

Table 9

Differences in total revenues and expenses according to clinic characteristics

Table 9

a)Internal, surgery, obstetrics & gynecology, pediatrics, family medicine, not indicated.

*P<0.05, **P<0.01, ***P<0.001.

Table 10

Interrelationship between total revenues/exp. according to clinic characteristics

Table 10

*P<0.05, **P<0.01, ***P<0.001.

Table 11

Factor analysis of influences on total revenue and expenses of clinics

Table 11

*P<0.05, **P<0.01, ***P<0.001.