Transition to a Primary Care–Centered Healthcare System: A Structural Reform for Korean Healthcare
10.21215/kjfp.2026.16.1.33
- Author:
Serng Bai PAK
1
;
Sang-Hyun LEE
;
Kyung-Hee CHO
;
Juhwan OH
;
Sang-il LEE
;
Kunhee PARK
;
Jae-Heon KANG
;
Seung-Won OH
;
Hee Gyung KANG
;
Mihwa YOO
Author Information
1. Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
- Publication Type:Review Article
- From:
Korean Journal of Family Practice
2026;16(1):33-41
- CountryRepublic of Korea
- Language:English
-
Abstract:
Korea’s healthcare system is at a critical juncture as rapid population aging, rising chronic disease burdens, and fragmented care expose the limits of a hospital-centered, fee-for-service model. Although policy discussions have long emphasized strengthening primary care and introducing a “family doctor” system, past reforms have focused mainly on expanding services or redefining professional roles, without establishing clear accountability, care continuity, or aligned payment mechanisms. Consequently, primary care remains weak and responsibility for comprehensive patient management is diffuse. This article argues that meaningful reform requires redefining the primary physician as an accountable manager of longitudinal, coordinated care within an integrated delivery and payment framework. Drawing on experiences from the United States, the United Kingdom, and several European countries, it identifies common features of successful primary care–oriented systems, including patient registration, team-based care, risk-adjusted payment, and explicit outcome accountability. Based on these insights, the authors propose a Korean primary physician model tailored to solo and small-group practices while fostering regional collaboration. Core elements include voluntary patient registration, multidisciplinary primary care teams, risk-stratified care management, regional care networks, and a mixed payment model combining per-member-per-month payments, shared savings, and performance-based incentives. The article emphasizes phased pilot testing focused on operational feasibility. Ultimately, transitioning to a primary care–centered system is presented as a strategic necessity for sustainability and improved care continuity.
