[OUTLOOK]Put hospitals under a microscopeSeveral years ago, Rhyu Si-min, now the minister of health and welfare, presented an interesting report on the inspection of the administration by the National Assembly. He was at the time a member of the People’s Party for Reform. The report contained the death rate of cancer patients at 42 university hospitals across the country. The figures showed the number of patients that one hospital treated for a year and how many them died.
Many patients and their family members asked such questions as, “My father has had stomach cancer for 6 months. Which hospital should he go to?,” or, “What hospital is good for a patient with lung cancer?” Some people read my article about this report much later and asked questions one or two years later. The data were “rough” information that didn’t take into account seriousness of the patients’ conditions or their ages. But it was the first data of this kind, and it had an enormous impact on people.
There are 1,400 hospitals and 25,000 clinics in this country. If herbal medicine clinics and dental clinics are included, it is nearly impossible to count how many there are. Deciding which hospital or clinic to go to is a hard decision to make. Even when buying a piece of cloth, we are supposed to take a look at its price, quality and design. Things are even more difficult when dealing with our health and lives, whether one has a minor symptom or a serious illness.
Even though there is helpful data for making such a decision, ordinary people don’t have access to it ― people just ask their neighbors or friends. Sometimes they hear a rumor about a great doctor and then they wait to see him for one or two years. Without sufficient knowledge or information, they stick to what they believe.
The Internet, at least, now allows one to search for health information on blogs or Web sites, but people still can’t get enough information. They go to a range of hospitals and clinics, but they are not satisfied. They just end up spending a lot of money.
According to the National Health Insurance Corporation, 430,000 people went to more than seven different medical institutes during the first nine months of last year. During the same period, 200,000 people went to more than 10 medical institutes. But we can’t just blame them for being “medical treatment shoppers.”
Up until the late 1980s, there were few hospitals and clinics to choose from and doctors were granted a high social status. These days, 3,000 people obtain medical licenses every year, and hospitals and clinics come and go. Quality medical treatment is seen as a citizen’s right. Yet people still have a lack of information about hospitals.
To protect the citizens’ right to know, an evaluation system for medical services was introduced. Large hospitals were evaluated last year and small- and mid-sized hospitals were evaluated this year, with the results being issued publicly. I haven’t heard, however, of anyone using this data to help them decide which hospital to go to. This is because the evaluation focused on such things as facilities or meals, and the data didn’t show scores for other details. The quality of medical treatment ― the most important factor ― was not included.
Hospitals can’t advertise. A bill to allow hospital to run advertisements is pending at the National Assembly, but even if the bill were passed, advertisements would serve merely as a reference when choosing a hospital.
There is a way to see how good a hospital's medical treatment is ― that is, to publicize the results of major operations such as intestine transplants or brain surgery for each hospital and each doctor. Late last year the Health Insurance Review Agency tried to do so, releasing a list of hospitals that conducted heart surgery often or that specialized in it. This year, the agency is focusing on strokes. These reports are limited to a couple of diseases, however, so the information is insufficient to answer many patients’ various questions.
In the United States, 10 or so private and government institutes, such as the Joint Council on Accreditation of Healthcare Organizations, evaluate hospitals and doctors in many different ways. Most of the evaluating agencies release detailed data; some of them only present a list of the best institutes. Nevertheless, for 50 years the United States has evaluated medical treatment. In Great Britain, meanwhile, hospitals that receive good evaluation results are rewarded.
We need to diversify the categories for evaluation to include a general evaluation, evaluations for each major disease, treatment of senior citizens and the mentally disabled, and also for herbal medicine clinics. In this way, patients can have the exact information they need. Unlike those in Germany or Japan, our medical insurance system uses a single pool, so the statistics by the Health Insurance Corporation have enormous data. If needed, the government or hospitals can think about organizing an independent evaluation agency.
When Mr. Rhyu announced the death rate for cancer patients, he said, “There are no standards or information [available to us] when we choose a hospital. The government should release objective data regularly.” I doubt he forgot what he said.
* The writer is an editorial writer of the JoongAng Ilbo.
by Shin Sung-shik