Work

Impact of Medical Crisis on the Competency of Surgical Conduct Regarding Departmental, Institutional and Regional Distribution in Korea: A National Insurance Claim Data Analysis

Year: 2025

Type: article

Abstract: BACKGROUND: In February 2024, a nationwide medical crisis erupted in South Korea following the mass resignation of over 90% of trainee physicians in protest against the government's healthcare reform policy. Amid the ongoing crisis, the government initiated a series of restructuring activities aimed at concentrating high-complexity surgeries and critical care at tertiary hospitals, while redistributing low-complexity procedures to hospitals and clinics. However, the nationwide impact of the reform policy on high-complexity surgical practices, particularly in terms of institutional type, departmental specialty, and regional distribution, has not yet been assessed. METHODS: Using national insurance claims data from the Korean Health Insurance Review and Assessment Service, we analyzed 914 high-complexity surgical procedures across tertiary hospitals (n = 47), general hospitals (n = 331), and hospitals/clinics (n = 37,888). Claims data from February to July 2023 (pre-crisis) were compared with those from February to July 2024 (post-crisis), stratified by institutional type, medical specialty, and geographic region. RESULTS: = 0.186) were negligible. Oncological surgery in the capital region, which is home to a higher concentration of tertiary hospitals, decreased by 17%, while oncological surgery in around-capital and non-capital regions increased by 11% and 5%, respectively. CONCLUSION: During the Korean medical crisis in 2024, nationwide surgical capacity and systems for maintaining competency were significantly compromised. Although some procedures were offset by redistribution to lower-tier institutions or regional hospitals, most high-complexity surgeries-particularly those requiring critical care-did not recover.

Source: Journal of Korean Medical Science

DOI: 10.3346/jkms.2025.40.e288