J Korean Med Assoc.  2015 Jul;58(7):598-605. 10.5124/jkma.2015.58.7.598.

Healthcare policy and healthcare utilization behavior to improve hospital infection control after the Middle East respiratory syndrome outbreak

• Kim Y

• KMID: 2064915
• DOI: http://doi.org/10.5124/jkma.2015.58.7.598

Abstract

The recent outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infections in South Korea in May 2015 revealed that the Korean healthcare system and hospitals are highly vulnerable to hospital-spread infections. In a short period of time, MERS-CoV infection spread widely across Korea due to the unique characteristics of the Korean healthcare system including 1) hospitals with limited infection control capabilities, 2) a heavy dependency on private caregivers due to a nursing shortage, 3) emergency department overcrowding, and 4) healthcare-related patient behaviour such as hospital shopping. To prevent future outbreaks of emerging infectious diseases similar to MERS-CoV, the Korean healthcare system should be reformed and healthcare-related patient behaviour must change. To improve the performance of hospital infection control, the National Health Insurance service should pay more for hospital infection control services and cover private patient rooms when medically necessary, including for infectious disease patients. To reduce risks of hospital infection related to private caregiving, the nurse staffing level should be increased and hospitals should take full responsibility for inpatient nursing care. To reduce hospital shopping, the National Health Insurance service should introduce a differential fee schedule which pays more when primary care providers care for patients with common conditions and tertiary care providers care for patients with severe conditions. To incentivize patients for appropriate health care use, lower patient out-of-pocket payments should be combined with a differential provider fee schedule.

Keyword

Infection control; Nursing; Emergency department overcrowding; Primary health care; Healthcare utilization behavior

MeSH Terms

Caregivers
Communicable Diseases
Communicable Diseases, Emerging
Coronavirus
Cross Infection*
Delivery of Health Care*
Disease Outbreaks
Emergency Service, Hospital
Fee Schedules
Hospital Shops
Humans
Infection Control
Inpatients
Korea
Middle East*
National Health Programs
Nursing
Nursing Care
Patients' Rooms
Primary Health Care
Tertiary Healthcare

Figure

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  Figure 1 Estimated costs, by hospital infection control activities (Modified from Eom JS. Investigation of cost-reimbursement system for infection control in Korean hospitals. Korea Centers for Disease Control and Prevention: Chengju; 2014)[6].

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