Massive Closure of Pediatric Clinics and Exodus of Pediatricians in Korea
JH. KOO 1, H. YEO 2, HJ. AHN 3, JY. LEE 4,5
1 Innovation Center Operation Division, Health Insurance Review and Assessment Service, Wonju, Republic Of Korea
2 International Policy Research Division, Health Insurance Review and Assessment Service, Wonju, Republic Of Korea
3 Healthcare Coverage Research Division, Health Insurance Review and Assessment Service, Wonju, Republic Of Korea
4 Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic Of Korea
5 Public Healthcare Center, Seoul National University Hospital, Seoul, Republic Of Korea

INTRODUCTION
Concerns in Pediatric Healthcare
Recent issues include pediatric clinic closures and a shortage of pediatricians in the Korean healthcare system.
The decrease in specialist applicants and clinic availability threatens pediatric health.

AIM
Research Aim
To provide evidence for policy proposals by analyzing economic losses, examining the number of clinic closures during the pandemic, and tracking the relocation patterns of pediatric specialists.

METHOD
Data
Health insurance claims data from the Health Insurance Review and Assessment Service (2018-2022).
Analysis
Analyze health insurance expenses.
Identify pediatric clinic closures during the pandemic.
Investigate the occupational status of representatives from closed pediatric clinics as of December 2022.

RESULTS
Health Insurance Medical Expenses
[Overall Clinics]
(2019) 16,962 → (2020) 16,937
[Pediatric Clinics]
(2019) 801 → (2020) 465

Closure of the Pediatric Clinics
[Dec. 2019]
Total Pediatric Clinics: 2,228
[Dec. 2022]
Operational: 1,864 (83.7%)
Closed: 364 (16.3%)

Tracking Pediatricians from Closed Clinics
Pediatricians from Closed Clinics: 364
Returned to Pediatric Clinics: 59 (16.2%)
Employed Elsewhere: 240 (65.9%)
Retirees: 65 (17.9%)

CONCLUSIONS

Crisis in Pediatric Care
The reduction in pediatricians due to the continued decline in the pediatric population, COVID-19, and systemic inequities in healthcare are threatening primary care and shifting the burden to tertiary care institutions.
Notably, most pediatricians who closed their pediatric clinics chose to retire or pursue alternative medical departments or other hospital types, indicating the challenges of sustaining a viable practice solely within the pediatric domain.

Future Directions for Pediatric Care
In South Korea's healthcare system, anchored in fee-for-service reimbursement, a sharp decline in the number of patients immediately affects doctors' income.
The current system faces challenges in ensuring the sustainability of pediatric clinics while delivering high-quality healthcare to children.
This underscores the imperative to explore various incentive programs or alternative payment systems tailored to pediatrics, a discipline grappling with the impact of declining birth rates.

REFERENCES
1 Yoo HH, You J. Barriers to Choosing Pediatrics as a Specialty: Insights from a Cross-sectional Analysis. Journal of Korean Medical Science 2024; 39(29):e211.
2 Suh DI. The Decline in Pediatric Residency Applications: Negative Perception of Pediatric Careers and Prospects. Journal of Korean Medical Science 2024; 39(29):e230.

CONTACT INFORMATION
Jun Hyuk Koo: koojh0210@hira.or.kr
Hyemin Yeo: hmyeo1@hira.or.kr
Hyo Jeong Ahn: rehab90@hira.or.kr
Jin Yong Lee†: jylee2000@gmail.com
† Corresponding author