The Organization for Economic Cooperation and Development has suggested Korea to increase the variety of college students admitted to medical faculties and introduce a pay-for-performance system.
With the present healthcare system, the nation can’t meet populating ageing and medical wants for persistent illnesses, it identified, whereas emphasizing the necessity to improve the long-term care system and strengthen home-based care providers.
These and different suggestions have been contained within the “OECD Economic Surveys: Korea 2022,” launched by the membership of commercial nations on Monday. It is a biennial report based mostly on the OECD secretariat’s complete evaluation and analysis of member nations’ financial traits and insurance policies together with its coverage advice.
The OECD identified that though Korea constructed among the finest healthcare techniques in a brief interval, it falls in need of making ready for an ageing society.
It then cited Koreans’ undue reliance on specialists and hospital care as structural issues. The common hospitalization interval of Korean sufferers in acute care stood at 7.3 days, longer than the OECD common of 6.6 days. The variety of hospital beds in Korea was 12.4 per 1,000 inhabitants, hovering far above the OECD common of 4.5.
Pointing out that Korea’s healthcare system overly depends on hospitalization and specialist care, the report mentioned, “This overreliance is largely due to weak primary care, which does not function well enough as a gatekeeper authorizing specialist referrals and hospitalization.”
Korea’s quickest populating ageing in OECD signifies that a bigger share of Korea’s inhabitants is more likely to undergo from a number of persistent illnesses, it famous.
“Primary healthcare with promising innovations and telemedicine can boost the capacity of the health system to contain and manage future health crises and reduce unnecessary hospitalization of people who can be effectively treated outside of hospitals,” it added.
The increase of doctors can’t be postponed anymore … common practitioners’ share should rise by introducing a pay-for-performance system
To strengthen major care, the report mentioned it’s pressing to replenish common practitioners (GPs) who will present major care providers.
It then suggested Korea to increase the medical faculty enrollment quota and introduce the pay-for-performance system.
The share of GPs in Korea stays at 6 %, far under the OECD common of 23 %. The scarcity is much more severe in Korea the place the variety of physicians per 1,000 inhabitants is smaller than different OECD members, in response to OECD. The variety of medical doctors per 1,000 individuals in Korea was 2.5, decrease than the OECD common of three.5. Accordingly, Korea must develop the variety of admissions to medical faculties and put together for an ageing society.
“Currently, Korean primary care is lacking in general practitioners. It will get even more serious soon, with many GPs nearing retirement and a declining number of new graduates specializing as GPs,” it mentioned. “In 2020, the government decided to increase the number of admitted students in medical schools but it has been delayed due to Covid-19 and opposition from doctors’ associations. However, this should be implemented without further delays, in light of rapid aging.”
The OECD report suggested the introduction of a pay-for-performance system to encourage purposes for GPs. The scheme pays bonuses to physicians who obtain pre-defined targets, reminiscent of decrease weight problems charges, smoking cessation, and persistent illness administration. Among OECD member nations, the U.Ok., the Netherland, and Portugal are implementing it.
The present fee-for-service scheme makes individuals choose specialists. People have a tendency to treat specialists present higher-quality care than GPs, and assume it is higher to see a specialist if it is the identical value, it mentioned.
“Shifting away from the current fee-for-payment scheme while blocking patients from bypassing GPs when accessing specialists and hospitals could increase the attractiveness of the GP profession and better meet the challenges posed by an aging population and the rising burden of chronic conditions,” it mentioned. “Studies suggest that the introduction of the pay-for-performance scheme in the United Kingdom is associated with higher retention of GPs, improved primary care quality, and increased job satisfaction.”
Long-term care reform will decrease social hospitalization and cut back the aged’s burden
The OECD additionally emphasised the necessity to reform long-term care because the old-age security internet. As lengthy as OECD sees it, Korea is a rustic that has a uncommon common long-term care system however failed to stop older adults from unduly resorting to hospitalization.
In Korea, the common size of keep per affected person at long-term care (LTC) hospitals was 165 days in 2019, the longest amongst OECD member nations. The variety of “social hospitalization” neared 170,000, accounting for 40 % of whole sufferers at LTC establishments.
This runs counter to the long-term care system’s goal of lowering the financial burden of aged sufferers and stopping social hospitalization in LTC establishments for acute care. OECD cited as causes the barren major care atmosphere, the inadequate connection between medical service and care, and the shortage of low-cost home-based medical service.
“In Korea, using hospitals is financially more attractive for care recipients than using LCT institutions or homecare,” the report mentioned. “While the national health insurance has a ceiling on co-payment according to income levels, the long-term care insurance does not. The flat-rate per diem reimbursement system should also be changed. The government should discourage private care providers and homecare medical service institutions from staging unsustainable and consumptive price competitions.”
The key to homecare lies in visiting nurse system … develop their autonomy
OCED additionally cited the availability of high-quality homecare providers as a serious job. The report, whereas mentioning that “the lack of visiting nurse service was the primary cause of unmet needs in at-home healthcare,” known as for increasing monetary sources and securing the workforce.
In 2020, the proportion of visiting nursing providers amongst all house medical providers stood at only one.6 %. This contrasts with that 64.2 % of long-term care recipients in Korea cited visiting nursing as essentially the most important service. Of the 20,000 individuals who wanted visiting nursing providers, solely 7.4 % may obtain it.
“Between 2010 and 2018, the number of long-term care recipients redoubled but that of nurses remained almost the same. About 74 percent of long-term care nurses are working part-time,” it mentioned. “Low wages, poor working conditions, and insecure employment contracts are blocking the release of new nurses.”
The OECD report additionally suggested increasing the autonomy of nurses in care and remedy.
“It is difficult for nurses in Korea to provide treatment autonomously. Regulations restrict nurses from treating patients according to their best judgment,” it said. “It is necessary to strengthen the autonomy of nurses in the care field and increase economic benefits. In Scandinavian countries, highly educated nurses could increase their role by having greater autonomy at work.”
