The government will significantly tighten the designation standards for tertiary general hospitals that specialize in treating severe patients. The aim is to ease the concentration of patients at large hospitals.
The Ministry of Health and Welfare said on the 20th that it has preannounced legislation for a revision of the Rules on the Designation and Evaluation of Tertiary General Hospitals, which is intended to steer large hospitals toward focusing on their core role of high-difficulty medical procedures and to strengthen their function as the last line of defense for severe and emergency care.
For university hospitals and other facilities with large bed capacity to be designated as tertiary general hospitals, the share of severe cases—patients who are difficult to treat—must be raised from the current 34% to at least 38%, while the share of mild cases—patients with minor illnesses—must be lowered from 7% or less to 5% or less. That is the crux of this revision.
For hospitals, this means they will need to accept more severe patients and refer mild cases to local clinics if they want to score well in the government's relative evaluation.
The staffing calculation method will also shift significantly to focus on inpatients. Previously, having a nurse care for three outpatients was recognized as equivalent to caring for one inpatient, but going forward a nurse must care for 12 outpatients to be converted to one inpatient. This is a measure to deploy more nursing staff to inpatient care.
A mandatory rule was also newly established requiring the placement of education-dedicated nurses to train new nurses and others.
The government expects the revision to refocus tertiary general hospitals on their original role of treating severe and high-difficulty cases and to normalize the medical delivery system. In particular, it is aiming to ease longer wait times caused by patient concentration at large hospitals and to improve the quality of treatment for severe patients.
However, access to tertiary general hospitals may become more difficult for mild cases. The government instead plans to steer patients to primary and secondary medical institutions to improve overall system efficiency.
The government has included special provisions to account for hospitals' preparation time. Hospitals that apply for designation by the end of this year will be subject to the current standards through Apr. 2, but from then until the end of June they must meet the tightened 38% share for severe patients and 5% for mild patients. The ministry will collect opinions on the revision through May 26.
For hospitals, failure to precisely manage patient data during this mixed-calculation period could severely damage their qualification status. Tertiary general hospital designation standards are legal requirements directly linked to the fee schedule that determines hospitals' reimbursement. Hospital officials commonly note that failing reassignment could lead to financial losses such as losing type-based additional charge payments depending on hospital size.
There are 47 tertiary general hospitals in the fifth cycle, operating from Jan. 2024 to Dec. 2026, nationwide. They include Kangbuk Samsung Hospital, Konkuk University Hospital, Kyunghee University Hospital, Korea University Guro Hospital, Samsung Medical Center, Seoul National University Hospital, Severance Hospital, Asan Medical Center, Seoul St. Mary's Hospital, Ewha Womans University Mokdong Hospital, Chung-Ang University Hospital, Hanyang University Hospital, GangNeung Asan Hospital, Kyungpook National University Hospital, Chungbuk National University Hospital, Chungnam National University Hospital, Pusan National University Hospital, Ulsan University Hospital, Chonnam National University Hospital, and Wonkwang University Hospital.