As Korea rapidly ages, the country is witnessing significant transformations in its elder care market. The Korean Convalescent Hospital Association (KCHA), representing the interests of convalescent hospitals since 2003, boasts 546 registered members out of 1,383 convalescent hospitals. This association plays a pivotal role in shaping the elder care landscape in Korea. Hyuk Ga, Chair of the Academic committee at the KCHA (Korean Convalescent Hospitals Association) shared his insights in the following about the future development of the long-term care market in Korea.
Types and future of Long-term Care Facilities in Korea
Long-term care facilities in Korea are mainly divided into Convalescent Hospitals (LTC hospitals) covered by National Health Insurance and Nursing Homes under National LTC Insurance. According to Ga’s research report on the “Long-term care system in Korea” published in AGMR, LTC hospitals provide a range of medical services, from subacute to long-term care, palliative care, and rehabilitation. As of June 2020, there are 1,481 LTCHs across the nation. These hospitals have gained popularity due to their coverage under the National Health Insurance (NHI) Program, which requires only 10%–20% out-of-pocket costs. The main focus of LTCHs is on medical care and rehabilitation, facilitating patients' return home. Their affordable fees make them a preferred choice for many older adults.
Recently, the Korean government has been advocating for community care services, providing comprehensive care at home rather than the institutional settings. This shift mirrors Japan's policy promoting community-based care services.
Consequently, convalescent hospitals are pivoting towards specialized post-acute care and rehabilitation services for patients recovering from major surgeries, strokes, cancer, or severe fractures, as stable cases may soon be excluded from institutional admission.
Technological advancements in elder care
Korea, renowned for its technological prowess, has introduced various advanced equipment for long-term care. Ga shared that assistive technologies aiding activities of daily living (ADLs) such as mobility, bathing, and toileting are widely utilized. Dementia care has also seen significant advancements with tools designed to manage behavioral and psychological symptoms, including multisensory environments like Snoezelen and entertainment software. However, the widespread adoption of these technologies faces challenges due to insurance limitations, as many of these advanced services are not covered.
Exemplary long-term care facilities
According to Ga, a growing emphasis on human rights for older adults has led to the promotion of the ‘4 No’s and 2 escapes’ campaign over the past decade, advocating for "No smells," "No restraints," "No bedsores," "No falls," and encouraging "escape from diaper wearing" and "escape from bed." This campaign is a hallmark of human rights in Korean long-term care, exemplified by many member hospitals, including Eson Hospital, known for its exceptional implementation of these principles.
Long-term care system in Korea
Since the early 1960s, Korea has experienced rapid socioeconomic development and demographic transitions, leading to an aging population. As of April 2020, 15.9% of the Korean population is aged 65 years or older, expected to reach 37.0% by 2050, the second highest among OECD countries. Traditionally, elder care in Korea was family-based, influenced by Confucian principles. However, modernization and urbanization have shifted care from homes to institutional facilities.
The implementation of the Long-Term Care Insurance (LTCI) system in 2008, modeled after Japan’s system, has been pivotal. The LTCI provides both in-kind and cash benefits, including home care and institutional care services. The LTCI eligibility process is thorough, ensuring that only those in need receive benefits. Despite high satisfaction rates, the system faces financial challenges due to increasing demand.
Planning for the new community care system
In November 2018, the Ministry of Health and Welfare (MOHW) announced Community Care projects to address financial shortfalls in LTCI services. This initiative, launched as a trial in June 2019, aims to provide integrated support for lodging, healthcare, day-care, and independent living at home. The service will expand by 2026 to accommodate Korea's super-aged society. The MOHW proposes various models, including comprehensive patient assessments, in-home services, and home hospice care. However, the shift from institutionalized care to home-based care poses challenges due to its deep-rooted familiarity with institutionalized care among citizens and the need for physician agreement.
Korea, one of the fastest-aging countries, faces significant social burdens from elder care. While nursing homes and LTCHs remain common, the government plans to implement integrated community care by 2025.
Conclusion
Korea’s elder care market is evolving rapidly, with a strong focus on integrating advanced technologies and shifting towards community-based care. The KCHA continues to advocate for improved care standards and innovative approaches, ensuring a robust future for elder care in Korea.
For more information, visit the Korean Convalescent Hospital Association’s official website or contact them directly through the provided email address.
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