Why Korea's Registered Hospitals Fell from 3,115 to 1,664 in 2017

How far did the count fall in the year of the 2017 registration renewal?

By 1,451. The national figure, which is the sum of the 17 regions, went from 3,115 in 2016 to 1,664 in 2017, a decrease of 46.6% (1 − 1,664 ÷ 3,115).

The 3,115 recorded for 2016 is the largest of the 14 yearly values in the source. After 2017 the figure rose to 1,957 in 2018 and 2,051 in 2019, and both were smaller than the 2016 value.

The source has no nationwide row and does not define its figures. How the national figure is put together is explained in How to Read Korea's Foreign Patient Hospital Statistics.

Why did the 2017 registration renewal take place?

Because an Act that took effect on June 23, 2016 required institutions already registered to renew within one year of that date. In a press release dated May 15, 2017, the health ministry gave June 22, 2017 as the renewal deadline.

Korea introduced registration for attracting foreign patients in 2009 under the Medical Service Act. The Act on Support for Overseas Expansion of Healthcare System and Attraction of International Patients was enacted on December 22, 2015 and took effect on June 23, 2016. Article 2 of its addenda treated medical institutions and facilitators already registered under the Medical Service Act as registered under the new Act, on condition that they meet the Article 6 requirements and renew within one year of the effective date.

The May 15, 2017 press release states that a registration not renewed by the deadline becomes subject to cancellation. It adds that attracting foreign patients while a registration is cancelled can bring up to three years in prison or a fine of up to 30 million won. The same release describes renewal as a system newly introduced by the Act.

What did the 2017 registration renewal require of an institution?

At least one specialist per department and medical malpractice liability insurance. The health ministry's June 26, 2017 press release says existing institutions had to take out liability insurance, on top of the specialist requirement, and then renew.

• Specialists: at least one for each department
• Annual coverage limit of the liability insurance: at least 100 million won for clinics and hospitals, at least 200 million won for general hospitals
• Validity of a registration: three years from the registration date (Article 6 of the current Act)
• When to apply for renewal: within the two months before the registration expires (Article 6 of the current Enforcement Rule)

Article 6 of the current Act keeps the same two registration requirements: at least one specialist for each department, and medical malpractice liability insurance or membership of a medical liability mutual aid association. Registration was with the Minister of Health and Welfare when the Act was first enacted and is with the city or provincial governor under the current Act.

Renewal did not end in 2017. The May 15, 2017 press release says every registered institution and facilitator must renew every three years. The steps for looking up whether a given institution is registered are in How to Check if a Korean Hospital Is Registered for Foreign Patients.

Is the 1,560 announced after the 2017 registration renewal the same number as the 1,664 in the statistics?

It cannot be treated as the same number. The 1,560 counts, by number of applications, the medical institutions that had renewed or newly registered as of June 2017, while the 1,664 is the 2017 value of a statistic that comes with no definition.

The June 26, 2017 press release reports 2,607 institutions and facilitators in all. Of these, 1,560 were medical institutions and 1,047 were facilitators. The release explains that, out of 4,234 cumulative registrations since the system began in 2009, those with no patient results or no intention to renew under the stricter standard (insurance and so on) were excluded and some registered anew.

No document explaining how the two numbers relate was found. K-Medical Tourism Institute does not use the 1,560 as the 2017 value of the statistics and does not calculate a difference between the two. The statistics file gives no reason for the 2017 decrease. The addenda and the two press releases confirm this much: a renewal took place that year, and institutions with no patient results or no intention to renew were excluded.

Which regions lost the most institutions in the year of the 2017 registration renewal?

In number of institutions, Seoul lost the most (672). All 17 regions had a smaller value in 2017 than in 2016.

The largest falls in number were in Seoul (672), Gyeonggi (198) and Busan (186). Together these 3 regions lost 1,056, which is 72.8% of the national fall of 1,451 (1,056 ÷ 1,451). The smallest falls were in Sejong (1), Ulsan (9) and Jeju (10).

The order changes when the fall is measured as a percentage. The largest percentage falls were Sejong 100.0% (1 to 0), Gyeongbuk 64.5% (31 to 11), Daejeon 63.6% (99 to 36) and Gangwon 63.6% (22 to 8), and the smallest were Jeju 23.8% (42 to 32), Ulsan 37.5% (24 to 15) and Jeonbuk 40.6% (32 to 19). Seoul fell 40.8%, less than the national 46.6%.

Did the counts return to their 2016 level after the 2017 registration renewal?

The national figure stays below its 2016 value through 2022. It was 2,051 in 2019, or 65.8% of the 2016 value, and 2,023 in 2022, or 64.9% (2,051 ÷ 3,115 and 2,023 ÷ 3,115).

In 2019 the only place at or above its 2016 value was Sejong 1 (100.0% of 1 in 2016). In 2022 the regions at or above their 2016 value were Incheon 104 (101.0% of 103 in 2016), Gwangju 96 (143.3% of 67 in 2016), Ulsan 26 (108.3% of 24 in 2016) and Sejong 1 (100.0% of 1 in 2016).

The 2022 national figure includes 12 for Gyeonggi. Gyeonggi was 151 in 2021, and its 2022 value is far out of line with earlier years, with no reason given in the source. Adding only the 16 regions other than Gyeonggi gives 2,011 for 2022, which is 72.9% of their 2016 sum of 2,759 (2,011 ÷ 2,759).

The national figure fell once more in 2020. That period is covered in What Happened to Korea's Registered Hospitals During COVID-19?, and all 14 years of regional values are in Korea Medical Tourism Hospitals by Region.