건강보험 청구자료를 활용한 국내 입원전담전문의 제도의 현황 분석 및 개선방안

Abstract

Background: With the aim of improving the safety and quality of medical care of inpatients, the hospitalist system was implemented as a pilot project from September 2016 in Korea. Based on the clinical results from the pilot project, the government promoted the hospitalist system to a regular service in January 2021 with the establishment of a new fee schedule. In this study, the current status of the hospitalist system in Korea and suggestions for the future direction of the new system are described. Methods: Data on hospitalists’ demographics were obtained from the Ministry of Health and Welfare through a request for information disclosure. The claims data for the fee schedule of the hospitalist service was obtained from the Health Insurance Review and Assessment Service database and analyzed. Results: As a result of analyzing the national health insurance claim data from 2018 to 2021, the use of the hospitalist system was concentrated in tertiary hospital and metropolitan areas. In addition, the proportion of weekday model in which hospitalists treat patients only during the daytime was higher than the full-time model in which hospitalists treat patients all day. Conclusion: The national implementation of the hospitalist system is a key paradigm shift in inpatient care. Therefore, all patients should be able to benefit from the hospitalist system regardless of the region or the healthcare institution. For the successful implementation and spread of the hospitalist system, further efforts including changes in the fee schedule are essential.