J Korean Med Assoc.  2016 Apr;59(4):248-250. 10.5124/jkma.2016.59.4.248.

The direction of reform for health care delivery system

  • 1Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. phealth@snu.ac.kr
  • 2Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea.


Rebuilding a health care delivery system is one of the most important tasks the Korean health system is facing. Health institutions need to each establish their own appropriate roles in rebuilding the system. Community clinics should act as institutions providing primary care services. Small/medium-sized hospitals should act as community general hospitals or shift their functions to specialized care hospitals. Large hospitals should treat inpatients with severe status and act as education and research institutions. Infrastructure reform is an essential component of rebuilding the system. Reimbursement for health institutions and copayment of patients should change from a cost-based system to a value-based system. It is also important to support the facilitation of cooperation between clinics and hospitals. The classical image of a health delivery system is that of a pyramid (vertical) structure. However, the WHO suggests that a health delivery system should be a network structure. Within this conceptual framework, a community clinic should act as a hub of coordination among health-related community resources. The balance between benefits and drawbacks is essential to adjust among conflicting interests while rebuilding the system.


Health care delivery system; Primary health care

MeSH Terms

Delivery of Health Care*
Hospitals, General
Primary Health Care
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