Work

Disparities in implementation of the South Korean hospitalist programme: a nationwide longitudinal study

Year: 2026

Type: article

Abstract: Objectives This study aimed to examine the implementation of South Korea’s hospitalist programme under a centralised national reimbursement framework, focusing on expansion and differences in adoption patterns by hospital type, region and coverage model.Methods We conducted a retrospective longitudinal study using nationwide administrative and claims data. All hospitals, wards and hospitalists adopting the hospitalist programme were included. Hospitalist status data from mandatory Ministry of Health and Welfare reports were analysed from March 2021 to September 2024, and hospitalist-specific National Health Insurance claims data were analysed from January 2021 to December 2023. Coverage models were classified as 5-day daytime, 7-day daytime or full-coverage model. Temporal trends in hospitals, wards, hospitalists, patients, insurance claims and total claims amount were assessed.Results Hospitals, wards and hospitalists increased 1.35-fold, 1.79-fold and 1.39-fold, respectively. Patients receiving hospitalist care increased significantly over time (β=139.08; 95% CI 44.21 to 233.95; p=0.005), as did total claims amount (β=14.94; 95% CI 4.87 to 25.01; p=0.005). Insurance claims showed a non-significant upward trend (β=683.52; 95% CI −59.20 to 1426.24; p=0.07). 7-day and full-coverage models expanded predominantly in tertiary-care hospitals and metropolitan areas, whereas 5-day coverage increased mainly in community hospitals and non-metropolitan areas.Discussion Routine national health data enabled longitudinal monitoring of programme implementation and identified uneven diffusion of more comprehensive coverage models across institutional and regional settings.Conclusion The hospitalist programme expanded steadily, but adoption patterns differed by coverage model, hospital type and region. Data-informed, context-sensitive workforce and reimbursement policies may be needed to support balanced nationwide development.

Source: BMJ Health & Care Informatics

DOI: 10.1136/bmjhci-2026-102399

Authors: Kyung Mee Park, Yoon Bin Jung, Myeongjee Lee, Kang Young Lee, Eun Lee

Institutions: Yongin Severance Hospital, Yonsei University, Yonsei University Health System

Language: English

Topic: Healthcare Policy and Management

Subfield: Economics and Econometrics

Field: Economics, Econometrics and Finance

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $2,207