Medical institutions in Korea spend 151 million won ($137,904) per physician to run a hospitalist system on average, with additional 20 million won to settle the system, a report showed.

Yonsei University’s Institute of Health Services Research on Monday submitted the final report, “A study on the introduction of hospitalist system for the improvement of hospitalization quality,” to the Health Insurance Review and Assessment Service (HIRA). Professor Jang Seong-in led the study.

According to the report, a hospitalist worked 53.2 hours a week on average, including night duties and weekend shifts, and received 147 million won in salary. Based on assumptions that they worked 40 hours a week, a hospitalist was paid 117 million won a year.

A medical institution had to spend 151 million won per physician, including salary, to run a hospitalist system. The operating cost was 4 million won per physician per year.

Hospitalists in province get more pay, work 10 hours longer per week

The salaries of hospitalists working in provinces were 9 percent higher than those in the Seoul metropolitan area, and the cost at medical institutions in provinces running a hospitalist system was 2 percent higher than those in the metropolitan area.

The average salary of hospitalists in the metropolitan area stood at 140 million won, and that of those in provinces, 153 million won. Hospitalists in provinces worked 58.9 hours per week, 10 hours longer than 48.5 hours of those in the metropolitan area.

The average salary of internal medicine hospitalists was about 150 million won, and that of surgical hospitalists, 138 million won.

The report estimated that a hospital would need 172.5 million won in total to run a hospitalist ward. Setting the salary of a hospitalist at 120 million won based on 40-hour work a week, the researchers applied 56 hours of work a week. The estimation is about 20 million won higher than the current level.

The report said it would be desirable that a hospitalist receives 42,339 won of medical payment per patient a day. The figure is at a similar level to the combination (42,490 won) of the medical payment under the pilot program (30,490 won) and the policy-related additional cost (12,200 won).

‘Korea needs to spend \750 billion to secure 5,000 hospitalists’

The expansion of the hospitalist system is a worldwide trend but Korea needs more research to find the right speed and the right size, the report noted.

In the U.S., 61,000 people work as hospitalists, and the number is increasing by 3,000 every year. In Japan, there is a separate department called “Hospital General Medicine” under which more than 1,300 are working as hospitalists. Their number has been rising by more than 200 a year since 2010.

The report forecast that hospitalists would grow in number in Korea due to reduced working hours for interns and residents, just as those in the U.S. did.

For hospitalists to tend patients in 68,000 wards – 50 percent from tertiary hospitals, 30 percent from general hospitals, and 4 percent from smaller hospitals -- the nation will need about 5,000 physicians exclusively working as hospitalists, or 4 percent of all the Korean doctors. The Korean government will need about 750 billion won in healthcare expenses, the report estimated.

“If the expansion of the hospitalist system goes steady and takes about 20 years, the government will need 180 billion won after five years,” the report said.

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