[2026 Parliamentary Audit] 510,000 Patients Referred by Tertiary Hospitals... Only 19% Treated at Partner Hospitals

4 in 10 referred patients revisit tertiary general hospitals within a month
So Byunghoon points to "inadequate follow-up care"

Only 2 out of every 10 patients referred back by tertiary general hospitals were confirmed to have actually received care at a partner hospital. Four out of every 10 patients who were referred back returned to a tertiary general hospital within a month, but the government was found to be unable to properly distinguish even the reasons for their return visits.

According to data submitted by the Health Insurance Review & Assessment Service (HIRA) to So Byeonghun, a Democratic Party of Korea lawmaker on the National Assembly Health and Welfare Committee, a total of 509,822 patients were referred back through specialized referral arrangements from 47 tertiary general hospitals across the country between October 2024 and April 2026.

Of these, 98,632 patients were confirmed to have actually received care at partner hospitals, representing just 19.3% of the total. The annual rate of confirmed treatment rose from 11.5% between October and December 2024 to 20.0% in 2025, but fell back to 18.6% between January and April 2026.

The follow-up care system for confirming whether patients continued to receive appropriate treatment after being referred back was also found to be inadequate. HIRA counts a specialized referral-back case as "completed" if the patient receives care at a partner hospital just once. However, critics say it is difficult to determine from a single visit whether a patient continued to receive the treatment they needed or whether their treatment had concluded.

Patients who were referred back also frequently returned to tertiary general hospitals. An analysis of 374,308 patients referred back between October 2024 and January 2026 found that 150,149 (40.1%) returned to a tertiary general hospital within 30 days. Another 54,392 patients (14.5%) returned between 31 and 90 days after referral.

HIRA says that return visits may include scheduled follow-up care, such as post-surgical monitoring, or treatment for a new condition, so a return visit alone cannot be deemed a failure of the referral-back process. The problem, however, is that HIRA does not distinguish between reasons for return visits, such as issues with treatment for an existing condition and a new condition, and does not separately track or analyze each patient's treatment progress.

Oversight of medical institutions with poor performance was also found to be inadequate. HIRA provides funding at different rates based on each institution's performance indicators, but it does not operate a system to separately designate and oversee institutions whose performance has deteriorated. Its ability to comprehensively assess patient inconveniences arising during the referral-back process, including delays in care, longer travel distances and medical expenses, was also limited.

"The purpose of restructuring tertiary general hospitals is not to send large numbers of patients to other hospitals, but to ensure that patients receive the care they need without interruption at medical institutions suited to their conditions," So said. "If only 19% of the 510,000 patients referred back were confirmed to have received care at partner hospitals, we must first take a close look at how the rest of the patients continued their treatment."

He added, "The government's responsibility must not end with sending patients to other hospitals. We need to establish a patient-centered follow-up care system that confirms whether patients actually receive care and whether their treatment continues after referral, and that analyzes the causes of poor performance and takes corrective action at underperforming medical institutions."

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