Direction of Health Care and Health Insurance System Reform to Strengthen Primary Care: Comparative Analysis of Korea, Japan and Taiwan

Park, Kidong

Abstract

BACKGROUND: This study aims to find the direction of health care and health insurance system reform to strengthen primary care in Korea.
METHODS
A comparative analysis was performed on health care system and health insurance system between Korea, Japan, and Taiwan.
RESULTS
(1) Functional differentiation between the hospital and the clinic is unclear and many clinics run beds for in-patient care. However, Japan and Taiwan have clear rule on the function of the hospital and the clinic, and only temporary observation beds are allowed for the clinic. (2) Health service delivery system is not defined in the Korean Health care Act. However, Japan and Taiwan have rules on health service delivery system in their health care act. (3) The system of co-payment ceiling is operated in Japan and Taiwan, but not in Korea. And Taiwan has various co-payment system including exemption of co-payment to fulfill the mission of health security. (4) Japan and Taiwan have many fee schedules for enforcing primary care, while Korea has little.
CONCLUSION
Health care and health insurance system should be reformed in order to strengthen primary care. Most of all, the role of the hospital and the clinic should be classified. Fee schedule for primary care should be changed to encourage coordinated management of chronic diseases. Reform of co-payment system is also required.