Ministry addresses overly crowded hospital rooms

Social Affairs

Published: 21 Oct. 2014, 08:19

Ministry addresses overly crowded hospital rooms

When Mr. Choi’s wife was ready to deliver their first baby, he wanted her to have a single-patient room in the maternity hospital. The birth was a moment the couple had been awaiting for 10 years, but the delivery was complicated, and the mother-to-be needed a cesarean because their baby was lying in a breech position.

“I was willing to pay for my wife to use the single-patient room because I knew how she was struggling,” he said. “She stayed in the hospital for five days, and the costs were so expensive, about 1.5 million won [$1,405].”

But if the couple were to have a second child two years from now, the financial pressure in paying for a single-patient room in a maternity hospital would be significantly diminished.

“In the case of maternity hospitals, we are considering applying the national health insurance policy to single-patient rooms,” said Song Young-rae, an official at the Ministry of Health and Welfare.

After the ministry examines the proposal next month, it will be reviewed by a health insurance policy deliberation committee.

If all goes according to plan, the policy would take effect in the second half of next year.

As it is currently envisioned, patients will only have to pay 20 percent of single-patient room hospitalization fees - or about 40,000 to 60,000 won per night out of the approximately 200,000 to 300,000 won total. The rest would be covered under Korea’s national health insurance program.

Of 195 nationwide community hospitals surveyed in 2012, there were 16 patient rooms that could accommodate 11 or more people. Six-patient rooms were the most common, totaling 502, according to the Korea Health Industry Development Institute.

But though many patients often choose to be treated in a six-patient room, mainly for its inexpensiveness, they must endure a stressful and largely inconvenient medical environment. A curtain that surrounds the sickbed is a patient’s only means of privacy, and comfortable treatment is hardly expected due to such limited space.

“Asian countries like Korea and Japan have multi-patient rooms in hospitals; but in the case of Japan, the government has begun to reduce the number of those rooms by providing financial support toward hospital infrastructure,” said Park Su-kyeong, a researcher at the Korea Health Industry Development Institute.

In the United States, most rooms accommodated single patients by the 1970s, but when Korea first implemented its national health insurance system in 1977, the country lacked hospitals. As a result, most medical centers equipped themselves with multi-patient rooms in order to handle the influx of people, and until recently, that setup was considered standard.

Prior to the government’s announcement to review covering single-patient rooms via insurance, the Health Ministry implemented a plan last month that would enable four- and five-person rooms to be covered under the health insurance program.

That proposal came nearly 30 years after the mandate that allowed rooms for six or more patients to be covered by insurance. Those rooms generally cost around 10,000 won per night.

Last month, the ministry also calculated that the cost of hospitalization in a four-patient room was about 1.6 times more expensive than in a six-patient room, part of an effort to prompt hospitals to convert their six-patient rooms into four-patient rooms.

But that came with some unexpected responses. One small-size hospital in Seoul removed one bed in half of its four-patient rooms to convert them into three-patient spaces - which are currently not covered by insurance - as earnings from hospitalization fees decreased. The hospital then raised the price of its three-patient rooms from 11,000 won to 14,000 won.

However, “even though we changed the four-patient rooms into three-patient rooms, we still cannot compensate for the money we’ve lost,” a hospital employee said.

Two university hospitals also raised the cost of single-patient rooms as their earnings shrank. One raised its fee from 37,000 won per night to 40,000 won, and the other increased it from 26,000 won to 40,000 won.

But conditions are even worse at small hospitals. One Gyeonggi hospital operates an 18-patient room, as well as 46 rooms that accommodate 10 people or more.

And though the medical environment differs depending on the needs of each patient, the fees for a six-patient room and a 16-patient room remain the same across the board.

While medical law regulates the minimum space required per room, it neither takes into account the space that medical equipment takes up nor stipulates certain criteria on facilities.

“In apartments, we use separate rooms for each person, and now we have to look at changing the hospital environment to use single-patient rooms,” said An Hyeong-sik, a professor in the department of preventive medicine at Korea University’s College of Medicine.

In an unprecedented plan, Ewha Womans University Medical Center recently announced that it would build a new medical facility with 1,000 single-patient rooms to be covered under health insurance. The project is expected to be completed in 2016.

But despite the good news, there are still some hurdles: Health insurance regulations stipulate that 70 percent of the rooms in a new hospital must accommodate six patients. The mandate, however, is currently under government review.

“The cost of hospitalization should be calculated depending on the quality of a patient’s room so that overly crowded patient rooms - for example, those that accommodate 18 patients - are eradicated,” said Park, the researcher. “To regulate the maximum number of sickbeds in a patient’s room to four would be another option for new hospitals.”

BY SHIN SUNG-SIK [ypc3c@joongang.co.kr]