Disparities in implementation of the South Korean hospitalist programme: a nationwide longitudinal study
5 affiliations
- 1Department of Hospital Medicine, Yongin Severance Hospital, Yongin-si, Korea (the Republic of)
- 2Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
- 3Yonsei Institute for Digital Health, Yonsei University, Seodaemun-gu, Korea (the Republic of)
- 4Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
- 5Department of Psychiatry, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
Abstract
Objectives: This study aimed to examine the implementation of South Korea’s hospitalist programme under a centralised national reimbursement framework, focusing on expansion and differences in adoption patterns by hospital type, region and coverage model.
Methods: We conducted a retrospective longitudinal study using nationwide administrative and claims data. All hospitals, wards and hospitalists adopting the hospitalist programme were included. Hospitalist status data from mandatory Ministry of Health and Welfare reports were analysed from March 2021 to September 2024, and hospitalist-specific National Health Insurance claims data were analysed from January 2021 to December 2023. Coverage models were classified as 5-day daytime, 7-day daytime or full-coverage model. Temporal trends in hospitals, wards, hospitalists, patients, insurance claims and total claims amount were assessed.
Results: Hospitals, wards and hospitalists increased 1.35-fold, 1.79-fold and 1.39-fold, respectively. Patients receiving hospitalist care increased significantly over time (β=139.08; 95% CI 44.21 to 233.95; p=0.005), as did total claims amount (β=14.94; 95% CI 4.87 to 25.01; p=0.005). Insurance claims showed a non-significant upward trend (β=683.52; 95% CI −59.20 to 1426.24; p=0.07). 7-day and full-coverage models expanded predominantly in tertiary-care hospitals and metropolitan areas, whereas 5-day coverage increased mainly in community hospitals and non-metropolitan areas.
Discussion: Routine national health data enabled longitudinal monitoring of programme implementation and identified uneven diffusion of more comprehensive coverage models across institutional and regional settings.
Conclusion: The hospitalist programme expanded steadily, but adoption patterns differed by coverage model, hospital type and region. Data-informed, context-sensitive workforce and reimbursement policies may be needed to support balanced nationwide development.
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BibTeX
@article{park2026disparities,
title = {{Disparities in implementation of the South Korean hospitalist programme: a nationwide longitudinal study}},
author = {Kyung Mee Park and Yoon Bin Jung and Myeongjee Lee and Kang Young Lee and Eun Lee},
journal = {BMJ Health \& Care Informatics},
year = {2026},
month = oct,
doi = {10.1136/bmjhci-2026-102399},
url = {https://doi.org/10.1136/bmjhci-2026-102399},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Disparities in implementation of the South Korean hospitalist programme: a nationwide longitudinal study
AU - Kyung Mee Park
AU - Yoon Bin Jung
AU - Myeongjee Lee
AU - Kang Young Lee
AU - Eun Lee
PY - 2026
DA - 2026/10/28
JO - BMJ Health & Care Informatics
DO - 10.1136/bmjhci-2026-102399
UR - https://doi.org/10.1136/bmjhci-2026-102399
AB - Objectives: This study aimed to examine the implementation of South Korea’s hospitalist programme under a centralised national reimbursement framework, focusing on expansion and differences in adoption patterns by hospital type, region and coverage model. Methods: We conducted a retrospective longitudinal study using nationwide administrative and claims data. All hospitals, wards and hospitalists adopting the hospitalist programme were included. Hospitalist status data from mandatory Ministry of Health and Welfare reports were analysed from March 2021 to September 2024, and hospitalist-specific National Health Insurance claims data were analysed from January 2021 to December 2023. Coverage models were classified as 5-day daytime, 7-day daytime or full-coverage model. Temporal trends in hospitals, wards, hospitalists, patients, insurance claims and total claims amount were assessed. Results: Hospitals, wards and hospitalists increased 1.35-fold, 1.79-fold and 1.39-fold, respectively. Patients receiving hospitalist care increased significantly over time (β=139.08; 95% CI 44.21 to 233.95; p=0.005), as did total claims amount (β=14.94; 95% CI 4.87 to 25.01; p=0.005). Insurance claims showed a non-significant upward trend (β=683.52; 95% CI −59.20 to 1426.24; p=0.07). 7-day and full-coverage models expanded predominantly in tertiary-care hospitals and metropolitan areas, whereas 5-day coverage increased mainly in community hospitals and non-metropolitan areas. Discussion: Routine national health data enabled longitudinal monitoring of programme implementation and identified uneven diffusion of more comprehensive coverage models across institutional and regional settings. Conclusion: The hospitalist programme expanded steadily, but adoption patterns differed by coverage model, hospital type and region. Data-informed, context-sensitive workforce and reimbursement policies may be needed to support balanced nationwide development.
SN - 2632-1009
ER -