Korean surgical associations demand fairer reimbursement for complex procedures

The Korean Surgical Association and the Korea Laparoscopic Surgery Society of Secondary Hospitals have launched a Hospital Committee to address the financial instability of regional secondary surgical hospitals. The committee, comprising approximately 30 hospitals, aims to propose realistic policy improvements to prevent the collapse of essential medical services.

A primary concern is the current Diagnosis Related Group (DRG) system, which provides uniform compensation for similar disease groups. Surgeons argue this fails to account for clinical variations, such as the difference in resources required for a simple appendicitis versus one complicated by peritonitis or abscess. They are calling for a more sophisticated reimbursement model that reflects surgical difficulty, emergency status, and actual medical costs.

Additionally, the committee is seeking compensation for the costs of maintaining 24-hour surgical teams. Currently, insurance payouts focus on performed procedures, leaving hospitals to bear the fixed costs of standby personnel and operating rooms during non-surgical hours. The group also intends to advocate for the recognition of surgical expertise in the upcoming 2028 national colorectal cancer screening program and to prevent insurance companies from using standardized criteria to deny coverage for varicose vein surgeries.