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Original Articles
National Trends in Healthcare Quality in Korea: A Multidimensional Assessment Using OECD Health Care Quality Indicators (2008–2023)
Hyejin Lee, Soo-Hee Hwang, Sang-A Cho, Hyemin Jung, Youngs Chang, Jieun Yun, Sanghyun Cho, Un-Na Kim, Hye Yeon Koo, Eun Byul Cho, Do Hee Kim, Jin Yong Lee
J Prev Med Public Health. 2026;59(3):225-238.   Published online May 20, 2026
DOI: https://doi.org/10.3961/jpmph.26.233
  • 4,571 View
  • 39 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Assessing healthcare quality at the national level is essential for evaluating health system performance and identifying areas requiring improvement. This study examined long-term trends in healthcare quality in Korea from 2008 to 2023 using internationally comparable indicators.
Methods
We conducted a trend analysis of healthcare quality in Korea using the Organization for Economic Cooperation and Development (OECD) Health Care Quality and Outcomes framework and quality indicators. Indicators across multiple domains, including acute care, primary care, prescribing in primary care, mental healthcare, and patient experiences, were analyzed and compared with OECD averages.
Results
Healthcare quality in Korea improved across several domains. Thirty-day mortality for acute myocardial infarction decreased from 14.2% in 2008 to 10.2% in 2023, while mortality for ischemic stroke declined from 8.7% to 5.5%. Avoidable hospitalizations decreased substantially, with hospitalizations for chronic obstructive pulmonary disease declining by 59.7%. The proportion of patients with diabetes receiving cholesterol-lowering treatment increased from 44.1% to 82.5%. However, the proportion of broad-spectrum antibiotic prescriptions remained substantially higher than the OECD average (40.3 vs. 15.5%). In mental healthcare, excess mortality ratios increased from 4.3 in 2010 to 4.9 in 2023 for schizophrenia and from 3.5 to 4.3 for bipolar disorder, while post-discharge suicide rates showed little improvement. Patient experience indicators related to patient-physician communication improved and approached OECD averages.
Conclusions
Healthcare quality in Korea improved substantially between 2008 and 2023, particularly in acute care outcomes and chronic disease management. However, persistent challenges remain in areas such as antibiotic use, polypharmacy, and mental healthcare. These findings provide internationally comparable evidence to inform future health policy and healthcare quality improvement efforts.
Summary
Korean summary
이 연구는 OECD Health Care Quality Indicators(HCQI)를 활용하여 2008년부터 2023년까지 한국 의료의 질 변화를 주요 OECD 국가와 비교·분석하였다. 분석 결과, 한국의 급성기 치료 성과(급성심근경색과 허혈성·출혈성 뇌졸중의 30일 사망률)와 만성질환 관리 수준(천식·만성폐쇄성폐질환·심부전·당뇨병의 입원율 감소와 당뇨병 환자의 적절한 약물치료 증가)은 전반적으로 향상된 것으로 나타났다. 그러나 광범위 항생제 사용, 고령층 다약제 처방, 중증 정신질환자의 초과사망 및 퇴원 후 자살률 등은 여전히 OECD 평균 대비 취약한 영역으로 나타나, 지속적인 질 관리와 정책 개선이 필요하다.
Key Message
This study analyzed changes in healthcare quality in Korea from 2008 to 2023 compared with major OECD countries using the OECD Health Care Quality Indicators (HCQI). Acute care outcomes and chronic disease management improved overall, including reduced 30-day mortality for acute myocardial infarction and stroke and lower hospitalization rates for major chronic diseases. However, broad-spectrum antibiotic use, polypharmacy among older adults, excess mortality among patients with severe mental illness, and post-discharge suicide rates remained worse than the OECD average, highlighting the need for continuous quality improvement and policy reform.
Necessity of Analyzing the Korea Community Health Survey Using 7 Local Government Types
Seowoo Park, Haibin Bai, Jae-ryun Lee, Soomin Kim, Hyemin Jung, Jin Yong Lee
J Prev Med Public Health. 2025;58(1):83-91.   Published online November 5, 2024
DOI: https://doi.org/10.3961/jpmph.24.388
  • 8,875 View
  • 495 Download
  • 1 Web of Science
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study examined the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size as a more effective tool to address local health problems and deduce practical implications.
Methods
Retrospective survey data from 2023 KCHS were obtained. Frequency analyses were performed for self-rated good health status, current smoking status, and unmet medical needs as proxies for health status, as well as health behavior and healthcare utilization, utilizing individual weights to represent national community residents.
Results
We established a new classification of local governments into 7 types to facilitate regional comparisons. These local government types are presumably composed of populations showing statistically significant differences in demographic characteristics. There were evident differences in health status, health behavior, and healthcare utilization in comparisons of groups categorized by local government types.
Conclusions
This study suggests that regional disparities can be analyzed using a new typology of local governments. This practically effective approach could be used in decision-making for community-centered health projects in terms of community health planning. Future research should conduct analyses of KCHS data that use these 7 local government types to comprehensively reflect regional characteristics.
Summary
Korean summary
이 연구는 지방자치단체 층위와 도·농복합시를 포함한 도시화 정도, 인구 규모를 고려한 분류 기준을 사용하여 지역사회건강조사(KCHS)에 대한 새로운 분석틀의 가능성을 검토한다. 기초 지방자치단체 7가지 유형으로 분류했을 때, 연구 대상자 집단은 인구 통계학적 특성에 대해 유의미하게 달랐으며 건강 상태, 건강 행태 및 의료 이용에 뚜렷한 차이를 보였다. 이 연구는 지역보건의료계획 측면에서 지역사회 중심 건강증진사업에 대한 의사 결정에 실질적으로 효과적인 접근 방법이 될 수 있는 기초 지방자치단체의 새로운 유형을 제안한다.
Key Message
This study examines the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size. In comparisons of groups categorized by 7 local government types, populations were significantly different considering demographic characteristics and there were evident differences in health status, health behavior, and healthcare utilization. This study suggests a new typology of local governments which could be a practically effective approach in decision-making for community-centered health projects in terms of community health planning.
Factors That Affect Suicidal Attempt Risk Among Korean Elderly Adults: A Path Analysis
Junsoo Ro, Jongheon Park, Jinsuk Lee, Hyemin Jung
J Prev Med Public Health. 2015;48(1):28-37.   Published online January 14, 2015
DOI: https://doi.org/10.3961/jpmph.14.030
  • 15,427 View
  • 170 Download
  • 5 Crossref
AbstractAbstract PDF
Objectives
Among the Korean elderly (those 65 years of age and older), the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey) that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects.
Methods
Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson’s correlation test, and path analysis.
Results
Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts.
Conclusions
Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.
Summary

Citations

Citations to this article as recorded by  
  • Association between sarcopenia and suicidal ideation in a nationwide population-based study
    Eyun Song, Soo Yeon Jang, Min Jeong Park, Ahreum Jang, Kyeong Jin Kim, Ji Hee Yu, Nam Hoon Kim, Hye Jin Yoo, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Kyung Mook Choi
    Scientific Reports.2025;[Epub]     CrossRef
  • Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence
    Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
    BMC Public Health.2022;[Epub]     CrossRef
  • Suicidal Behavior Among Elderly Inpatients: its Relation to Functional Disability and Pain
    Suzaily Wahab, Tien Yong Chua, Rosdinom Razali, Zanariah Mat Saher, Iman Hakimi Zamzam, Mohamad Adam Bujang
    Psychology Research and Behavior Management.2022; Volume 15: 737.     CrossRef
  • Parks and green areas and the risk for depression and suicidal indicators
    Kyoung-bok Min, Hyun-Jin Kim, Hye-Jin Kim, Jin-young Min
    International Journal of Public Health.2017; 62(6): 647.     CrossRef
  • Prevalence and Predictive Factors of Depression in Community-Dwelling Older Adults in South Korea
    Jae Soon Yoo, Sun Ju Chang, Hyun Sook Kim
    Research and Theory for Nursing Practice.2016; 30(3): 200.     CrossRef
The Impact of an Emergency Fee Increase on the Composition of Patients Visiting Emergency Departments
Hyemin Jung, Young Kyung Do, Yoon Kim, Junsoo Ro
J Prev Med Public Health. 2014;47(6):309-316.   Published online November 24, 2014
DOI: https://doi.org/10.3961/jpmph.14.044
  • 12,118 View
  • 119 Download
AbstractAbstract PDF
Objectives
This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits.
Methods
We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions.
Results
The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes.
Conclusions
A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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