Last Year, Hospitalization Rate for Minor Injury Patients at Oriental Medicine Hospitals Reached 16.3% under Auto Insurance
Premium Room Charges for Minor Injury Patients Rose to 24.7 Billion KRW
"Hospitalization Criteria for Minor Injury Patients Need to Be Clarified"
Even after the system reform regarding premium hospital rooms for minor injury patients under auto insurance, the proportion of hospitalizations and medical expenses continues to rise, particularly at oriental medicine hospitals.
According to the Korea Insurance Research Institute on May 25, the annual hospitalization rate of auto insurance minor injury patients at oriental medicine hospitals increased from 12.8% in 2021 to 16.3% in 2024, a rise of 3.5 percentage points. During the same period, the rate at oriental medicine clinics rose from 5.7% to 6.6%, an increase of 0.9 percentage points, while the rate at general medical institutions decreased from 9.3% to 5.9%, a drop of 3.4 percentage points.
An illustration depicting an increase in the use of premium hospital rooms by patients with minor injuries at an oriental medicine hospital. ChatGPT
In November 2022, the Ministry of Land, Infrastructure and Transport revised the auto insurance medical fee standards to allow coverage for premium hospital rooms (1- to 3-person rooms) for up to seven days only in hospitals or higher-level institutions, and only if there are no general wards available or if medically necessary. This change was made to prevent certain small oriental medicine clinics from claiming excessive medical fees by operating high-priced premium rooms, effectively blocking insurance coverage for such practices at the clinic level. However, the same problem is now recurring at oriental medicine hospitals.
The premium room charges for minor injury patients at oriental medicine clinics have decreased, in line with the intent of the system reform. However, the increase at oriental medicine hospitals has accelerated. The premium room charges for minor injury patient hospitalizations at oriental medicine clinics dropped sharply from 26.3 billion KRW in 2021 to 210 million KRW in 2024. In contrast, at oriental medicine hospitals, the figure surged by 128.7%, from 10.8 billion KRW in 2021 to 24.7 billion KRW in 2024.
The rise in hospitalizations of auto insurance minor injury patients at oriental medicine hospitals leads to an increase in injury compensation payments, highlighting the need for comprehensive measures to curb this trend. Jeon Yongshik, a senior research fellow at the Korea Insurance Research Institute, stated, "Currently, premium hospital room admissions are allowed for up to seven days if based on a doctor's judgment or if general wards are unavailable, but there needs to be a discussion to clarify the hospitalization criteria for minor injury patients." He added, "If the treatment period for minor injury patients exceeds eight weeks, stricter reviews of prolonged treatment periods are scheduled to be implemented, and the establishment of a dispute arbitration body is under consideration. In line with these measures, the criteria and duration for minor injury patient hospitalizations should also be reviewed."
There are also calls for mechanisms to prevent moral hazard among medical institutions such as oriental medicine clinics and hospitals. Jeon further pointed out, "Experts such as doctors have an information advantage over patients regarding their health status or injuries," and emphasized, "Because there are incentives to use this advantage for excess profits, it is necessary to strengthen legal regulations on professionals."
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