Journal of Preventive Medicine and Public Health

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

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Abstract Summary PDF Supplementary 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.

Who Dies Alone? Demographics, Underlying Diseases, and Healthcare Utilization Patterns of Lonely Death Individuals in Korea: Haibin Bai, Jae-ryun Lee, Min Jung Kang, Young-Ho Jun, Hye Yeon Koo, Jieun Yun, Jee Hoon Sohn, Jin Yong Lee, Hyejin Lee; J Prev Med Public Health. 2025;58(2):218-226. Published online March 4, 2025; DOI: https://doi.org/10.3961/jpmph.24.704

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2 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Lonely death is defined as “a person living in a state of social isolation, disconnected from family, relatives, and others, who dies from suicide, illness, or other causes”. This study investigated the characteristics of individuals who die alone in Korea.
Methods
We constructed a database of lonely death cases by linking data from the Korea Crime Scene Investigation Unit of the Korea National Police Agency with National Health Insurance Service (NHIS) records. A descriptive analysis was performed to evaluate the demographics, underlying diseases, and healthcare utilization patterns among lonely death cases.
Results
Among the 3122 individuals identified as lonely death cases, 2621 (84.0%) were male and 501 (16.0%) were female. The most common age group was 50-59 years (n=930, 29.8%). The NHIS covered 2161 individuals (69.2%), whereas 961 individuals (30.8%) were enrolled in Medical Aid (MA). The highest number of lonely deaths occurred in Seoul areas, with 1468 cases (47.0%). Mood disorders were diagnosed in 1020 individuals (32.7%), and various alcohol-related diseases, including alcoholic liver disease, were also observed. Outpatient visits increased leading up to death but declined in the final 3 months, while hospitalizations decreased and emergency room visits slightly increased.
Conclusions
Most lonely death cases involved male in their 50s, with a disproportionately high number of MA beneficiaries compared to the general population. Many of these individuals also experienced mental health issues or alcohol-related disorders. Preventing social isolation and strengthening social safety nets are critical to reducing the occurrence of lonely deaths.

Summary

Korean summary
한국에서 고독사란 법적으로 “가족, 친척 등 주변 사람들과 단절된 채 사회적 고립상태로 생활하던 사람이 자살ㆍ병사 등으로 임종”하는 것으로 정의하고 있다. 고독사 사망자는 대체적으로 50대 남성이었고, 의료급여 수급권자의 비율이 일반 인구보다 월등히 높았으며, 사망자 대다수는 정신건강 문제 또는 알코올성 질환을 앓고 있었다. 사회적 고립의 예방 및 사회안전망 구축은 고독사 예방에 있어 매우 중요한 역할을 할 것으로 보인다.

Key Message
Lonely death is defined as “a person living in a state of social isolation, disconnected from family, relatives, and others, who dies from suicide, illness, or other causes”. This study investigated the characteristics of individuals who die alone in Korea. Most lonely death cases involved male in their 50s, with a disproportionately high number of MA beneficiaries compared to the general population. Many of these individuals also experienced mental health issues or alcohol-related disorders. Preventing social isolation and strengthening social safety nets are critical to reducing the occurrence of lonely deaths.

Citations

Citations to this article as recorded by

Comparison of health care utilisation and spending among National Health Insurance and Medical Aid beneficiaries in Korea
Agnus M. Kim, Doojin Ryu, Jin Yong Lee
BMC Health Services Research.2026;[Epub] CrossRef
Understanding of solitary death in people living in the community: A scoping review
Chung Min Cho, Hyeun Jun Moon, Jee-Hye Yoo
Global Public Health.2025;[Epub] CrossRef

Perspective

What Else Is Needed in the Korean Government’s Master Plan for People With Developmental Disabilities?: Jin Yong Lee, Jieun Yun; J Prev Med Public Health. 2019;52(3):200-204. Published online May 7, 2019; DOI: https://doi.org/10.3961/jpmph.18.249

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Abstract Summary PDF Supplementary Material

On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a ‘welfare society in harmony.’ However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals’ unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.

Summary

Korean summary
2018년 9월 대통령이 직접 발표한 “발달장애인 평생케어 종합대책”의 성공적인 수행을 위해 필수적인 정책을 제안하였다. 특히, 발달장애인의 정확한 규모, 유병률, 발생률 등 기초적인 현황 파악과 정책 개발을 뒷받침하기 위한 역학연구, 발달장애인 개인평가에 기반한 미충족 필요의 측정과 이를 바탕으로 한 개인별 맟춤형 서비스 디자인, 서비스의 접근성과 형평성 달성, 그리고 보건-의료-고용-교육-복지서비스를 통합적으로 제공할 수 있는 시스템 구축이 필요함을 지적하였다.

Citations

Citations to this article as recorded by

Association between intellectual disability and autism spectrum disorder with kidney failure
Hye Yeon Koo, In Young Cho, Yong-Moon Mark Park, Kyung Mee Kim, Chung Eun Lee, Kyungdo Han
Pediatric Nephrology.2026; 41(7): 2063. CrossRef
Prevalence and severity of COVID-19 among children and adolescents with autism spectrum disorders in the Republic of Korea
Jieun Yun, Beomjun Kang, Jae-ryun Lee, Hyejin Lee, Jin Yong Lee
Autism.2023; 27(8): 2397. CrossRef
Prevalence and Premature Mortality Statistics of Autism Spectrum Disorder Among Children in Korea: A Nationwide Population-Based Birth Cohort Study
Seung-Mi Yoo, Kyoung-Nam Kim, Sungchan Kang, Hyun Joo Kim, Jieun Yun, Jin Yong Lee
Journal of Korean Medical Science.2022;[Epub] CrossRef
Determining the reasons for unmet healthcare needs in South Korea: a secondary data analysis
Boyoung Jung, In-Hyuk Ha
Health and Quality of Life Outcomes.2021;[Epub] CrossRef
Factors Underlying Unmet Medical Needs: A Cross-Sectional Study
Young Suk Yoon, Boyoung Jung, Dongsu Kim, In-Hyuk Ha
International Journal of Environmental Research and Public Health.2019; 16(13): 2391. CrossRef
The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study
Doori Kim, Seong-Gyu Ko, Eun-Kyoung Lee, Boyoung Jung
BMC Musculoskeletal Disorders.2019;[Epub] CrossRef

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