Improve Korea's hospitals

By Bernard Rowan

Korean hospitals occupy a middle-tier of quality that needs further improvement. As an advanced nation, Korea's health care provision through her hospitals must change to reach the standard of other advanced countries. This should occur while preserving Korea's valued practice qualities.

According to the SCIMAGO world ranking of hospitals (http://hospitals.webometrics.info/en), Korean hospitals don't make the first tier of global performers. Of the top 20 Korean hospitals, including Samsung, Seoul National, Asan, and other major university hospitals, none rank in the top World 100. Only two rank among the world's top 200 hospitals.

While many occupy the next levels, the rankings, though just one measure, say there's room for improvement. Korean hospitals must address obvious problems with their operating protocols attending the recent MERS crisis. This summer, one of Korea's best hospitals failed to diagnose and identify the patient illness until too late. While an elite hospital makes for easy scapegoating, it likely points to a wider tendency. Among the main changes should be protocols for handling patients with infectious diseases. Another concerns managing emergency rooms.

A 2012 OECD health care quality assessment of Korea (www.oecd.org/els/health-systems/49818570.pdf) provides related information highlighting areas for improvement. The report states a first and overriding need for higher prioritization of quality improvement by the Korean government, health care providers, and the public. Simply put, in Korea's busy and increasingly prosperous society, health care provision and quality haven't kept pace!

The report foreshadowed the MERS incident. It said, "The most pressing (need) is to develop better systems to monitor individual clinician performance, which can identify breaches in patient safety…"

The report warned of the need to shift the pattern of health care away from hospitals as providers of primary care. In an era of aging population and longer life expectancies, it also criticized how hospitals cost payment for services. Hospital budget practices are not up to present-day standards.

The report also focused on the lack of accredited hospitals in Korean society. Korean hospitals overprovide services at lower costs, increasing demands on one part of what should become a more fully-developed network of care. Korea needs to encourage the growth of clinics, urgent-care clinics, primary care practices, and alternatives to "going to the hospital." Korean hospitals provide too much primary care at lower than market costs.

More hospitals and primary care practices will lessen public flocking to those with high status. The varying regions of Korea face unequal access to quality care, primary and otherwise. A ripe area for national improvement concerns creating a national health care system that attends to regional needs and equality of provision.

Of course, one way to improve is by copying those hospitals at best practice. Among the top performers as well as the United States on the SCIMAGO rankings are hospitals from Paris, Taipei, Heidelberg, Xinqiao, and Leiden.

I also think it's important to provide positive support for some of the unique characteristics of Korean hospitals. Advancement often sees these fade into past practices, but I hope that won't occur.

When I lived in Korea, my experience of Korean hospital care was excellent. I should say my condition needed primary care. I had two serious ear infections that called for medical attention. While the physical appearance didn't rival those of other international hospitals in polish and modern style, the care for me as a patient was simply outstanding, the best I've experienced. The doctors and nurses showed great regard for my needs, explained to me clearly and in English my illness and treatment, and they did it all with an air of efficiency and consideration.

It's a strength of Korean hospitals to show a more "open arms" policy toward family members and friends. This easy target of critics has its benefits, but they aren't the kind captivating medical journals and ratings experts. Too many people in hospital increase risks of disease. However, care includes more than disease fighting. Honoring family and friends who pay visits and want to stay near a loved one isn't wrong. Respect for families does attend to other needs. But this custom wants more attention to mitigating risks.

Of course, fighting and curing diseases are the purpose of hospitals. To mitigate risk calls for creating more spaces for family and friends to stay near hospitals, including commercial and non-profit hotels, rest areas, and accommodation for short stays. Improved hospital quality needs stricter rules and enforcement around family and friends in emergency rooms and related areas.

This column only scratches the surface of this important issue. However, I'd like to encourage the continued prioritization of quality development in Korean hospitals. It'd form another evolution of Korea's success story as the Miracle on the Han River.

Bernard Rowan is associate provost for contract administration and professor of political science at Chicago State University, where he has served for 22 years. Reach him at browan10@yahoo.com.