Written by: APHN Editorial Team (South Korea)
APHN will like to thank Dr. Yong-Joo Lee, Clincal assistant professor, Department of palliative medicine, Seoul St. Mary’s Hospital, Catholic university and June C.W. Lee, Grief Counselor & SW, The Bobath Memorial Hospital, from Korean Society of Hospice & Palliative Care (KSHPC) for volunteering to join the news team and provide this update to us.
The Korean Society of Hospice & Palliative Care (KSHPC) updated that the Ministry of Health & Welfare Department of Korea has announced public health medical coverage for terminal cancer patients. This includes Hospice & Palliative Care service cost which will come into effect around July 2015. The coverage will include nursing aid fee and is expected to gradually expand to cover hospice home care service. This is a huge step forward as public health medical coverage designed for cancer patients were mainly focused on “Cure” rather than “Care” since 2005.
On 25th February, the Ministry of Health & Welfare held a forum in the auditorium of Health Insurance Review and Asessment Service (HIRA) at the Seoul office in Seocho-gu. The topic of the forum was “The restriction and boundaries of Hospice and Palliative Care medical coverage”. A “Public Health Medical Coverage for Hospice Care” was announced with the information gathered at the forum. With this coverage, hospice patients will be applied to Resource Utilization Group (RUG) public health medical coverage. However, the coverage excluded higher costs related to pain control in palliative care and primary consultation.
The RUG scheme will cover the cost for special unit such as a private room for dying process patient, counseling, music, art therapy, and integrative patient care. However, the ‘Fee for service’ system still remains for procedures like using of strong opioids, palliative radiation therapy and transfusion for hematologic malignancy.
The distinctive point of hospice & palliative care service in South Korea compared to the Western countries is that care is mostly focused on “In-patient”. Majority of the services are provided from hospitals, institutional wards, or hospice units and not in terms of “Home care”, contrary to services provided in the Western countries. This is an issue that most of the other Asian countries are facing too. In South Korea, Palliative Hospice care services have been sorted into three different divisions (High grade General hospital, General hospital, and Clinics) in accordance with number of Palliative care units, number of patient beds and quality of service. With the new Act in place, public health medical coverage will be available for all types of admission rooms in hospice & palliative care units or wards except the private rooms in the High grade General Hospital and General Hospital. In the past, a terminal cancer patient who is hospitalized in a 5-patient room in the hospice & palliative care unit will need to pay around 301,000 Won (KRW) for her stay. With the new coverage released in July, the patient’s total medical bill will be reduced to around 221,000 KRW.
The Ministry of Health & Welfare has additional plans for Hospice Home Care service as a Pilot Project this coming July too. The proposal of Hospice Home Care has been on the table since December 2009 and it took five more years for it to be approved as a Pilot Project. The reasons for delayed decision were due to death as a taboo topic among the Asians, denying talks about death and non-supportive coverage for the hospice or palliative care units. However, with the growing population of seniors, the quality of end of life care and awareness of hospice care has helped to drive the need for this act and plans for the project. Mr. Jae-Yong Lee, the head of Division of Disease and Welfare Policy, explained, “Till date, the number of clinics willing to operate hospice care units remain small. However, we will expect the New Act of public health medical coverage for terminal cancer patient in Hospice & Palliative Care to encourage more participating hospice & palliative care institutions due to the growing demand for quality of end of life care.”