A Study on Strengthening of Health Care Coverage Expansion and Sustainability Plans: Focused on Primary Care

Abstract

Korea Government announced the Benefit Expansion Plans of the National Health Insurance on August 7, 2017. The purpose of this plan was to increase the coverage rate up to 70% by decreasing the burden of medical cost. Between 2015 and 2019, the rate of overall health coverage increased by 0.8 percentage points to 64.2 percent but the rate of primary care clinic’s health coverage decreased by 8.3 percentage points to 57.2 percent. Patients are preferring the general hospitals due to the benefit expansion plans centered on the tertiary cares, and the role of primary care has been reduced. Noncovered services at the primary care clinic increased in line with decrease of the total medical expense and the number of patients at the local clinics. This study was to find the cause of non-covered service increase in the primary care and to propose some strategies for improvement of Korea Healthcare Delivery and new roles of primary care units in the health care system in view of efficiency and finance.