J Korean Med Assoc.  2013 Oct;56(10):856-865. 10.5124/jkma.2013.56.10.856.

Concept, values, current status and prospect of primary care in Korea

Affiliations
  • 1Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  • 2Tapdong 365-il Clinic, Jeju, Korea.
  • 3Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 4Department of Family Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea. jaeholee@catholic.ac.kr

Abstract

Primary care is an essential part of a whole health system. It is the first contact point for medical care in the community, where many people are likely to obtain their own impression of the health system. Primary care has its own attributes, such as first contact, continuity, comprehensiveness, and coordination, which are yardsticks for measuring its excellence. Regarding the value of primary care, many studies have reported extensive evidence of the advantages of primary care at individual and societal levels. Health systems with strong bases of primary care are better than those with weak ones in terms of cost, health outcomes, and quality of care. However, primary care in South Korea has continuously shrunk or been weakened for several decades. As people age and chronic illnesses become prevalent, more attention is being paid to primary care than ever before, and several policy options have been proposed. Therefore, if the medical community wishes to invigorate primary care, it should play a pivotal role in formulating and implementing primary care policies by envisioning primary care, establishing related data infrastructure, and continuing the discussion on long term goals like training primary care physicians.

Keyword

Primary care; Data infrastructure; Primary care physician; Health system

MeSH Terms

Chronic Disease
Health Care Costs
Humans
Korea
Physicians, Primary Care
Primary Health Care
Republic of Korea

Cited by  4 articles

Differences among Ophthalmology Patients Referred to Tertiary Medical Centers according to Referral Hospital
Heesuk Kim, Hong Kyu Kim, Tyler Hyungtaek Rim, Ji Won Kim, Jin Hyung Kim, Sung Soo Kim
Korean J Ophthalmol. 2018;32(3):190-195.    doi: 10.3341/kjo.2017.0090.

The direction of reform for enhancing primary care
Jung-Jin Cho
J Korean Med Assoc. 2016;59(7):482-485.    doi: 10.5124/jkma.2016.59.7.482.

Current status of health services research in primary care in Korea
Hee-Young Lee, Jong-Heon Park, Yong-Jun Choi
J Korean Med Assoc. 2016;59(11):888-895.    doi: 10.5124/jkma.2016.59.11.888.

Service Demand for and Awareness of a Primary Healthcare Pilot Project for People With Disabilities
Hye-Jin Kim, Soong-Nang Jang, Jae-Young Lim
J Korean Med Sci. 2022;37(30):e241.    doi: 10.3346/jkms.2022.37.e241.


Reference

1. White KL, Williams TF, Greenberg BG. The ecology of medical care. N Engl J Med. 1961; 265:885–892.
Article
2. Green LA, Fryer GE Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001; 344:2021–2025.
Article
3. Leung GM, Wong IO, Chan WS, Choi S, Lo SV. Health Care Financing Study Group. The ecology of health care in Hong Kong. Soc Sci Med. 2005; 61:577–590.
Article
4. Fukui T, Rhaman M, Takahashi O, Saito M, Shimbo T, Endo H, Misao H, Fukuhara S, Hinohara S. The ecology of medical care in Japan. JMAJ. 2005; 48:163–167.
5. Ferro A, Kristiansson PM. Ecology of medical care in a publicly funded health care system: a registry study in Sweden. Scand J Prim Health Care. 2011; 29:187–192.
Article
6. Shao CC, Chang CP, Chou LF, Chen TJ, Hwang SJ. The ecology of medical care in Taiwan. J Chin Med Assoc. 2011; 74:408–412.
Article
7. National Health Insurance Service. National Health Insurance Service statistics [Internet]. Seoul: National Health Insurance Service;2013. cited 2013 Jul 31. Available from: http://www.nhis.or.kr/cms/board/Download.jsp?fileId=63849&communityKey=B0074.
8. Blendon RJ, Kim M, Benson JM. The public versus the World Health Organization on health system performance. Health Aff (Millwood). 2001; 20:10–20.
Article
9. Blendon RJ, Benson J, Donelan K, Leitman R, Taylor H, Koeck C, Gitterman D. Who has the best health care system? A second look. Health Aff (Millwood). 1995; 14:220–230.
Article
10. Young GJ, Meterko M, Desai KR. Patient satisfaction with hospital care: effects of demographic and institutional characteristics. Med Care. 2000; 38:325–334.
11. Kotzian P. Determinants of satisfaction with health care system. Open Polit Sci J. 2009; 2:47–58.
Article
12. Saltman RB, Figueras J. Delivering services efficiently. In : Saltman RB, Figueras J, editors. European health care reform: analysis of current strategies. Copenhagen: World Health Organization, Regional Office for Europe;1997. p. 203–245.
13. Saltman RB, Rico A, Boerma WG. Primary care in the driver's seat? Organizational reform in European primary care. New York: Open University Press;2006.
14. Rittenhouse DR, Shortell SM. The patient-centered medical home: will it stand the test of health reform? JAMA. 2009; 301:2038–2040.
15. Atun R. What are the advantages and disadvantages of restructuring a health care system to be more focused on primary care services? [Internet]. Copenhagen: World Health Organization, Regional Office for Europe;2004. cited 2013 Oct 2. Available from: http://www.euro.who.int/document/e82997.pdf.
16. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005; 83:457–502.
Article
17. National Institute of the Korean Language. Standard grand language dictionary [Internet]. Seoul: National Institute of the Korean Language;2013. cited 2013 Aug 4. Available from: http://stdweb2.korean.go.kr/main.jsp.
18. Donaldson MS, Yordy KD, Lohr KN, Vanselow NA. Primary care: America's health in a new era. Washington, DC: National Academy Press;1996.
19. Starfield B. Primary care: balancing health needs, services, and technology. New York: Oxford University Press;1998.
20. Addison C. Future provision of medical services: report of the medical consultative council for England. Br Med J. 1920; 1:739–743.
Article
21. Kim SY. A new concept of primary care. J Korean Acad Fam Med. 1996; 17:114–124.
22. World Health Organization, Regional Office for Europe. Primary health care: main terminology [Internet]. Copenhagen: World Health Organization, Regional Office for Europe;cited 2013 Aug 6. Available from: http://www.euro.who.int/en/what-we-do/health-topics/Health-systems/primary-healthcare/main-terminology.
23. Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P. The European definition of general practice/family medicine. Warsaw: WONCA Europe;2011.
24. Lee JH, Choi YJ, Volk RJ, Kim SY, Kim YS, Park HK, Jeon TH, Hong SK, Spann SJ. Defining the concept of primary care in South Korea using a Delphi method. Fam Med. 2007; 39:425–431.
25. Starfield B. Is primary care essential? Lancet. 1994; 344:1129–1133.
Article
26. Greenfield S, Nelson EC, Zubkoff M, Manning W, Rogers W, Kravitz RL, Keller A, Tarlov AR, Ware JE Jr. Variations in resource utilization among medical specialties and systems of care: results from the medical outcomes study. JAMA. 1992; 267:1624–1630.
Article
27. Kravitz RL, Greenfield S. Variations in resource utilization among medical specialties and systems of care. Annu Rev Public Health. 1995; 16:431–445.
Article
28. Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy. 2002; 60:201–218.
Article
29. Kruk ME, Porignon D, Rockers PC, Van Lerberghe W. The contribution of primary care to health and health systems in low- and middle-income countries: a critical review of major primary care initiatives. Soc Sci Med. 2010; 70:904–911.
Article
30. Shi L. The relationship between primary care and life chances. J Health Care Poor Underserved. 1992; 3:321–335.
Article
31. Shi L. Primary care, specialty care, and life chances. Int J Health Serv. 1994; 24:431–458.
Article
32. Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970-1998. Health Serv Res. 2003; 38:831–865.
Article
33. Shi L, Starfield B, Kennedy B, Kawachi I. Income inequality, primary care, and health indicators. J Fam Pract. 1999; 48:275–284.
34. Shi L, Starfield B. Primary care, income inequality, and self-rated health in the United States: a mixed-level analysis. Int J Health Serv. 2000; 30:541–555.
Article
35. World Health Organization. The world health report 2008: primary health care now more than ever. Chapter 3. Primary care: putting people first [Internet]. Geneva: World Health Organization;2008. cited 2013 Aug 24. Available from: http://www.who.int/whr/2008/chapter3/en/index.html.
36. Mosquera PA, Hernandez J, Vega R, Martinez J, Labonte R, Sanders D, San Sebastian M. The impact of primary healthcare in reducing inequalities in child health outcomes, Bogota-Colombia: an ecological analysis. Int J Equity Health. 2012; 11:66.
Article
37. Stange KC, Ferrer RL. The paradox of primary care. Ann Fam Med. 2009; 7:293–299.
Article
38. Greenfield S, Rogers W, Mangotich M, Carney MF, Tarlov AR. Outcomes of patients with hypertension and non-insulin dependent diabetes mellitus treated by different systems and specialties: results from the medical outcomes study. JAMA. 1995; 274:1436–1444.
Article
39. Kwon S, Bae EY, Choi YJ. Current status and problems of health delivery system in South Korea. Healthc Policy Forum. 2010; 8:2–11.
40. Kim YK. Status and prospect of medical clinics in health system. Healthc Policy Forum. 2012; 10:16–23.
41. Cho YM. Current status and development plan of medical clinics: a perspective of customer. Healthc Policy Forum. 2012; 10:36–41.
42. Park SK. Reestablishment of functions of medical clinics and hospitals. Health Policy Forum. 2012; 10:25–31.
43. Jo HS. Strategies for improvement of primary care in Korea. J Korean Med Assoc. 2012; 55:959–968.
Article
44. Lee JH. Primary care and family medicine. Korean Academy of Family Medicine. Textbook of family medicine. Seoul: Hankook Book;2008. Vol. 1:p. 13–24.
45. Park SK. Korean Health Policy and Administration. Vision and prospect for activation of primary care. In : Proceedings of the 46th Academic Conference of Korean Health Policy and Administration; 2011 May 27; Seoul, Korea. Seoul: Korean Health Policy and Administration;2011. p. 117–140.
46. Bae SS, Kang MN, Kim GG, Kim JY, Park NS, Park IB, Shin DS, Jo HS, Choi YJ. Study of cardio- and cerebro-vascular disease prevention and improved management in Seoul. Seoul: Hallym University, Health Services Research Center;2010.
47. Yoon SJ. Rapid growth of large scale hospitals in the metropolitan area and realities of medical clinics. Healthc Policy Forum. 2012; 10:15–20.
48. Ministry of Health and Welfare. Master plan for reestablishment of functions of medical clinics and hospitals: the establishment of a patient-centered, sustainable health system. Seoul: Ministry of Health and Welfare;2011.
49. Yun H, Lee SI. Primary care and health care reform in Korea. Seoul: Korea Development Institute;2012.
50. Han DS. Current status and prospect of primary care in Korea. J Korean Acad Fam Med. 1996; 17:948–956.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr