A Critical Review of the Benefit Assessment in Public Hospital Preliminary Feasibility Analysis: Focusing on the Case of Ulsan Medical Center’s Emergency Mortality Reduction Benefit Estimation

Abstract

Despite long-standing discussions on strengthening public healthcare by building new public hospitals, progress in expanding these facilities remains slow. The preliminary feasibility studies, often cited as a primary cause of this situation, have sparked arguments that such assessments should be exempted when establishing public hospitals. The previous administration attempted to strengthen public healthcare by implementing these exemptions. However, a change in government led to some hospital projects being reassessed, effectively halting them. This suggests that the strategy of expanding public healthcare through exemptions from preliminary feasibility studies has implicit limitations. This paper focuses on the economic evaluation of preliminary feasibility studies, particularly the issue of emergency medical service benefit assessment, analyzing the case of Ulsan Medical Center. Our recalculation of the benefits and critical review of the preliminary feasibility studies for public hospitals revealed that the recalculated benefit-cost ratio is higher than initially estimated. This result indicates that the conclusions of the reassessment need to be reviewed. The paper aims to ensure that preliminary feasibility studies provide meaningful insights for public decision-making that aligns with people's needs, garner broader consensus, and contribute to building a healthcare system that transcends the logic of economic efficiency and rationality.