Evidence map›Paper›PMID 36348756›Full record

ArticleRisk management and healthcare policy2022

Expanding Medical Surge Capacity to Counteract COVID-19: South Korea's Medical Fee Adjustment Through the National Health Insurance System.

Eunji Yun, Hey Jin Ko, Boryung Ahn, Hyejin Lee, Won Mo Jang, Jin Yong Lee

Abstract read
In one paragraph

Article in Risk management and healthcare policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Eunji YunDivision of Pharmaceutical Policy Research, HIRA Research Institute, Health Insurance Review & Assessment Service, Wonju-si, Gangwon-do, Republic of Korea.ORCID 0000-0002-1262-5169
Hey Jin KoDivision of Healthcare Coverage Research, HIRA Research Institute, Health Insurance Review & Assessment Service, Wonju-si, Gangwon-do, Republic of Korea.ORCID 0000-0002-8328-3880
Boryung AhnDivision of Review and Assessment Research, HIRA Research Institute, Health Insurance Review & Assessment Service, Wonju-si, Gangwon-do, Republic of Korea.ORCID 0000-0001-6339-3874
Hyejin LeeDepartment of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeomggi-do, Republic of Korea.ORCID 0000-0001-5279-340X
Won Mo Jang *Department of Public Health and Community Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.ORCID 0000-0003-3277-7706
Jin Yong Lee *Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-7752-2697

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: South Korea has utilized its National Health Insurance (NHI) system to adjust the medical fees payable for healthcare services, to financially support the frontline healthcare providers combating COVID-19. This study evaluated the composition of such adjustments to the medical fees-made to secure resource surge capacity against the pandemic-in South Korea. Methods: Descriptive statistics and schematization were employed to analyze 3,612,640 COVID-19-related NHI claims from January 1, 2020, to June 30, 2021. COVID-19 suspected and confirmed cases were evaluated based on the proportion of fees adjustment, classified into space, staff, or stuff (3S) using diagnosis codes. The proportion of fees adjustment was investigated in terms of the healthcare expenditure, number of patients, and number of healthcare services covered. Findings: First, in terms of cost, medical fee adjustments covered over 96% of the total costs arising from the increased demand for testing (stuff) and isolated spaces among patients suspected of having COVID-19. Second, medical fees were adjusted to cover over 80% of the cost attributable to COVID-19 confirmed cases, in relation to isolated spaces and medical staff support. Third, the adjustment of less than 10% of the various types of medical fees, if selected strategically, can effectively induce a surge in resource capacity. Interpretation: South Korea has improved its existing surge capacity by adjusting the medical fees payable through NHI to healthcare providers. Particularly, through the provider payment system of fee-for-service, the Korean government could prevent the spread of infection and protect the medical staff assigned to respond to COVID-19. However, additional studies on alternative payment systems are needed to control costs while maintaining an effective pandemic response system in the face of the prolonged COVID-19 outbreak.

Indexed as

COVID-19fee-for-servicemedical feesnational health insuranceprovider payment systemsresource capacity

Identifiers

PMID36348756
PMCPMC9637364

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.