J Korean Med Assoc.  2013 Jun;56(6):523-532.

Comparative study on medical fees: caesarean section, cataract, and appendectomy surgeries among OECD countries

• Lee C
• Lee HJ
• Park SJ

Abstract

The question has been raised whether the medical fee schedule is very low in Korea. However, studies that empirically address this matter on a national scale are rare. This study attempted to determine the level of Korea's medical fees for caesarean section (C-section), cataract, and appendectomy surgeries by comparing and analyzing them with other Organization for Economic Cooperation and Development (OECD) countries' medical cost data obtained from other studies. There are two ways to compare the level of medical fees: one is a direct comparison, which obtains each country's medical fee schedule and compares them with each other. Another is indirect comparison, a method which compares data such as physician income. For direct comparison, fees were calculated using data provided by the OECD and Health Insurance Review and Assessment. For indirect comparison by physician income, data obtained from Korea Employment Information Services were used to represent Korean physician income. When compared with other OECD countries, the results suggest that, overall, the Korean fee schedule could be low, based on the fees for C-section, cataract, and appendectomy surgeries. The study results also confirm that Korean physicians' average earnings ranked relatively low among OECD countries. These results are meaningful in that they empirically support the contention that Korean medical fees could be low. In addition, under what is known as national health insurance, in which the medical fee schedule is determined by a single payer, an empirical analysis on medical fee levels, as in this study, has substantial political implications because it may be utilized for medical fee schedule negotiation in the near future. An attempt to directly research fees and the range of services of OECD countries is still needed in order to provide more established data.

Keyword

Medical fees; International comparison

MeSH Terms

Appendectomy
Appointments and Schedules
Cataract
Cesarean Section
Employment
Fee Schedules
Fees and Charges
Fees, Medical
Female
Information Services
Insurance, Health
Korea
National Health Programs
Negotiating
Pregnancy

Figure

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  Figure 1 Medical fee comparison by case categories: Organization for Economic Cooperation and Development countries (unit: US dollars). From Koechlin F, et al. Comparing price levels of hospital services across countries: results of a pilot study. Paris: Organization for Economic Cooperation and Development Publishing; 2010 [15].

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  Figure 2 Caesarean section, cataract surgery, appendectomy's medical fee schedule comparison. From International Federation of Health Plans. 2011 Comparative price report: medical and hospital fees by country. London: International Federation of Health Plans; 2012 [16] and Health Insurance Review and Assessment Service. DRG fee schedule (effective from 2012 Jun 1) [Internet]. Seoul: Health Insurance Review and Assessment Service; 2012 [21].

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  Figure 3 Average income ratio of general practitioner to other professions: comparison among Organization for Economic Cooperation and Development countries. From Fujisawa R, et al. The remuneration of general practitioners and specialists in 14 OECD countries: what are the factors influencing variations across countries? Paris: Organization for Economic Cooperation and Development Publishing; 2008 [17] and Korea Employment Information Service. OES: occupational employment statistics 2008 [Internet]. Seoul: National Human Resources Development; 2008 [22].

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  Figure 4 Average income ratio of specialists to other professions: comparison among Organization for Economic Cooperation and Development countries. From Fujisawa R, et al. The remuneration of general practitioners and specialists in 14 OECD countries: what are the factors influencing variations across countries? Paris: Organization for Economic Cooperation and Development Publishing; 2008 [17] and Korea Employment Information Service. OES: occupational employment statistics 2008 [Internet]. Seoul: National Human Resources Development; 2008 [22].

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  Figure 5 Indirect comparison of countries of selected countries. From Fujisawa R, et al. The remuneration of general practitioners and specialists in 14 OECD countries: what are the factors influencing variations across countries? Paris: Organization for Economic Cooperation and Development Publishing; 2008 [17] and Korea Employment Information Service. OES: occupational employment statistics 2008 [Internet]. Seoul: National Human Resources Development; 2008 [22].

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