"From Prevention to End-of-Life Care at Home: Strengthening Home-Based and Primary Medical Care"

Medical Innovation Committee Recommends Major Overhaul of Local Health System for Super-Aged Society
Public Health Centers to Focus on Strategy and Coordination, Community Institutions to Manage Resident Health
Expanded Mobile Clinics and Public

A recommendation has been made to completely overhaul the local public health and primary care systems so that, in response to the super-aged society, individuals can receive continuous health management in their communities, covering everything from disease prevention and treatment to care and end-of-life support.

On August 27, the Medical Innovation Committee held its 9th meeting at the Koreana Hotel in Jung-gu, Seoul to review the “Recommendations for Innovative Local Public Health and Primary Care Systems Responding to Preventive Healthcare Needs in a Super-Aged Society.”

The Committee observed that the existing disease treatment-centered medical system alone has its limits in responding to the complex health issues on the rise in a super-aged population, such as frailty, dementia, multiple chronic diseases, and polypharmacy. Therefore, the Committee proposed a transition to a community-based system whereby prevention and health management are provided close to where residents live.

The recommendations are aimed at establishing “a robust health safety net from prevention to end-of-life, regardless of where one lives,” and encompass four major strategies: ▲ innovation and enhancement of the local public health system ▲ defining and expanding the role of primary care and its community functions ▲ bolstering cooperation between local public health and primary care ▲ innovating the legal, financial, informational, and workforce foundations of the local healthcare system.

The Committee first recommended shifting the focus of the local public health system from individual institutions or business performance to “population health.” This approach sets policy goals around improving the overall health of community residents and reducing health inequalities, designing and evaluating policies based on outcomes in community health.

The roles of local public health institutions will also be reorganized. Municipal and district health centers will focus on strategy and planning for local health policy, public health crisis response, and the overall coordination and supervision of local public health. Functions such as providing prevention, health promotion, and care services close to where people live will be strengthened mainly through Health Lifestyle Support Centers and community health subcenters. In urban areas, Health Lifestyle Support Centers will be expanded in a balanced manner, while in rural and fishing communities, the roles of community health centers and health clinics will be reinforced and restructured according to local conditions. Expanding resident participation in local public health governance is also included.

“Primary Care”-Centered Integrated Community Care...Universalization of Home Healthcare

The recommendation also states that basic access to primary care in medically underserved areas, such as rural regions, should be the responsibility of both national and local governments. Depending on local conditions, a range of supply methods will be employed, such as strengthening the functions of community health centers and clinics, supporting private primary care institutions, expanding public-private collaborative primary care facilities, and providing mobile or outreach clinics.

The Committee noted that the role of primary care should move beyond the simple clinic-based disease treatment model. To ensure the core functions of primary care—first contact, comprehensiveness, continuity, and coordination—are fully realized, systems and compensation frameworks will be reorganized. The goal is for primary care to serve as the key institution for health management in the community, responsible for disease prevention, chronic disease management, and general health care close to residents.

The fragmented structure in which local public health and primary care operate independently by project will also be changed. The two domains will establish a cooperative system that jointly takes responsibility for the health of local residents and responds together to key community health issues.

In particular, the roles of local public health and primary care will be strengthened in community-integrated care. Preventing frailty, managing polypharmacy, managing discharged patients, and connecting visiting and home healthcare with integrated care will all be addressed, with the institutional foundation established to allow local public health and primary care institutions to meaningfully participate in integrated support meetings and the management of target groups.

Integration of Regional Health Data and Establishment of AI Platform

There was also a recommendation to tailor financing and evaluation systems to local health needs. Moving away from individual project-based national subsidies, resources will be allocated according to community health needs, and compensation and evaluation systems will be improved to foster cooperation between local public health and primary care.

Fragmented information on local public health, healthcare utilization, and integrated care will be standardized and connected into a single integrated information system. The plan includes developing and advancing an AI-based community health management platform that can identify health risks early and connect residents to the necessary services.

To increase stability of employment and expertise among local public health workers, the Committee proposed establishing national-level core competencies and education and training systems. The plan also envisions systematically linking local medical education from undergraduate health science programs to internships and continuing education.

The Committee recommended piloting innovative local public health and primary care programs in actual communities to test these changes. This approach would establish governance involving not only local public health and primary care institutions, but also the National Health Insurance Service, community resources, and resident representatives—focusing on resolving real health problems of the community population rather than the performance of individual organizations.

Jung Ki-hyun, Chair of the Medical Innovation Committee, stated, “In a super-aged society, we must transition to a system where people can proactively manage their health and receive necessary medical care and support continuously, close to wherever they live.” He added, “We hope these recommendations will serve as a starting point for local public health and primary care to move beyond their respective domains and take collective responsibility for residents' health.”

Meanwhile, on the same day, the Committee also discussed plans for public engagement in the second half of the year. On November 7–8, a second public deliberation forum will be held to collect public opinions on the topic of the “Life-Sustaining Treatment Decision System.”

This content was produced with the assistance of AI translation services.