ArticleJournal of chest surgery2025
Changes in General Thoracic Surgery Volume during the Medical-Political Conflict in South Korea by Institutional Type and Surgical Complexity: An Analysis of National Health Insurance Claims.
Article in Journal of chest surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed.
- Changes in American Society of Anesthesiologists Physical Status Distribution and Prognostic Performance During the 2024 South Korean Healthcare Crisis: A Large-Scale Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Allocative inefficiency in physician workforce distribution: specialty-level NHI-covered reimbursement analysis in South Korea's single-payer system.Frontiers in public health · 2026Article
- DRG-based payment and governance in high-complexity thoracic surgery: implications for efficiency and care delivery.Frontiers in health services · 2026Article
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Authors and funding
3 authors.
Funding
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Abstract
Background: In February 2024, South Korea experienced a major healthcare disruption following the mass resignation of approximately 86% of resident physicians in protest of a government-led medical reform. In response, the government introduced a policy that centralized high-complexity operations in tertiary hospitals and redirected low-complexity procedures to general hospitals and clinics. However, the nationwide impact of this policy on surgical distribution and volume remains unclear. Methods: A retrospective analysis was performed using nationwide claims data from the Korean National Health Insurance Service, accessed via the Health Insurance Review and Assessment Service (HIRA). General thoracic surgery volumes from February to July 2023 (pre-crisis) were compared to the same period in 2024 (post-crisis) across tertiary hospitals (n=47), general hospitals (n=331), and smaller hospitals/clinics (n=37,888). Surgical complexity was categorized using relative value units (RVUs), which reflect procedural intensity and resource requirements. Results: Overall thoracic surgery volume declined by 15% during the crisis. Tertiary hospitals reported a 22% reduction in procedures, while general hospitals and clinics recorded increases of 9% and 92%, respectively. High-complexity operations (≥30,000 RVUs) at tertiary hospitals fell by 22%, with only partial compensation by general hospitals. Low-complexity procedures (<30,000 RVUs) also decreased at tertiary hospitals but were not adequately redistributed. Conclusion: The 2024 healthcare crisis caused significant disruption to surgical capacity in South Korea. Although some redistribution occurred, the government's reallocation strategy did not fully achieve its intended goals. Recovery of pre-crisis surgical capacity, especially for high-complexity procedures, remains incomplete.
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