, Tae Hyun Kim2,3
, Suk-Yong Jang2,3
, Sang Gyu Lee1,3
1Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
2Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
3Department of Biohealth Industry, Graduate School of Transdisciplinary Health Sciences, Yonsei University, Seoul, Korea
Copyright © 2026 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of Interest
The authors have no conflicts of interest associated with the material presented in this paper.
Funding
None.
Acknowledgements
None.
Author Contributions
Conceptualization: Park JY, Lee SG. Data curation: Park JY. Formal analysis: Park JY. Funding acquisition: None. Methodology: Park JY, Kim TH, Jang SY, Lee SG. Visualization: Park JY. Writing – original draft: Park JY. Writing – review & editing: Park JY, Kim TH, Jang SY, Lee SG.
| Characteristics |
Included |
Excluded |
p-value | |||||
|---|---|---|---|---|---|---|---|---|
| Tertiary | Secondary | Total (n) | Tertiary | Secondary | Other1 | Total (n) | ||
| Location | 0.090 | |||||||
| Capital region | 21 (52.5) | 82 (40.4) | 103 | 1 (16.7) | 28 (36.4) | 16 (30.2) | 45 | |
| Non-capital region | 19 (47.5) | 121 (59.6) | 140 | 5 (83.3) | 49 (63.6) | 37 (69.8) | 91 | |
| Ownership type | <0.001 | |||||||
| National/Public | 11 (27.5) | 47 (23.2) | 58 | - | 5 (6.5) | 4 (7.5) | 9 | |
| Social welfare/Special foundation | 1 (2.5) | 5 (2.0) | 6 | 1 (16.7) | 3 (3.9) | 2 (3.8) | 6 | |
| Medical | 2 (5.0) | 102 (50.2) | 104 | - | 58 (75.3) | 40 (75.5) | 98 | |
| Private | 1 (2.5) | 18 (8.9) | 19 | - | 5 (6.5) | 7 (13.2) | 12 | |
| Educational | 25 (62.5) | 31 (15.3) | 56 | 5 (83.3) | 6 (7.8) | - | 11 | |
| Bed capacity2 | <0.010 | |||||||
| <200 | - | 20 (9.9) | 20 | - | - | 22 (41.5) | 22 | |
| 200–499 | - | 138 (68.0) | 138 | - | 19 (24.7) | 31 (58.5) | 50 | |
| 500–999 | 24 (60.0) | 44 (21.7) | 68 | - | 51 (66.2) | - | 51 | |
| 1000–1999 | 13 (32.5) | 1 (0.5) | 14 | 6 (100) | 7 (9.1) | - | 13 | |
| ≥2000 | 3 (7.5) | - | 3 | - | - | - | 0 | |
| Proportion of resident physicians (%)2 | <0.001 | |||||||
| <10 | - | 147 (72.4) | 147 | - | 62 (80.5) | 53 (100) | 115 | |
| 10–19 | 1 (2.5) | 23 (11.3) | 24 | 5 (83.3) | 15 (19.5) | - | 20 | |
| 20–29 | 7 (17.5) | 20 (9.9) | 27 | 1 (16.7) | - | - | 1 | |
| ≥30 | 32 (80.0) | 13 (6.4) | 45 | - | - | - | 0 | |
| Total | 40 (100) | 203 (100) | 243 | 6 (100) | 77 (100) | 53 (100) | 136 | |
| Variable of interest | Medical revenue-to-profit ratio (%) | Net income before reserve fund allocation per 100 beds1 |
|---|---|---|
| Model 1 (effect of time) | ||
| Year | −1.33 (−2.07, −0.59) | −0.89 (−2.75, 0.97) |
| COVID-19 | −1.55 (−2.86, −0.23) | 6.67 (3.36, 9.97) |
| Model 2 (effect of COVID-19) | ||
| Classification | ||
| Tertiary hospital | Reference | Reference |
| Secondary hospital | −1.90 (−7.27, 3.47) | −1.50 (−11.33, 8.34) |
| Region | ||
| Capital region | Reference | Reference |
| Non-capital region | 4.16 (1.28, 7.04) | 2.32 (−3.10, 7.74) |
| Ownership | ||
| National/Public | Reference | Reference |
| Social welfare/Special foundation | 6.77 (−2.37, 15.91) | −5.05 (−22.28, 12.19) |
| Medical | 16.40 (12.80, 20.00) | 4.73 (−2.05, 11.51) |
| Private | 11.05 (5.36, 16.74) | 2.58 (−8.15, 13.31) |
| Educational | 13.77 (9.41, 18.13) | 8.92 (0.75, 17.10) |
| Characteristics | Included |
Excluded |
p-value | |||||
|---|---|---|---|---|---|---|---|---|
| Tertiary | Secondary | Total (n) | Tertiary | Secondary | Other |
Total (n) | ||
| Location | 0.090 | |||||||
| Capital region | 21 (52.5) | 82 (40.4) | 103 | 1 (16.7) | 28 (36.4) | 16 (30.2) | 45 | |
| Non-capital region | 19 (47.5) | 121 (59.6) | 140 | 5 (83.3) | 49 (63.6) | 37 (69.8) | 91 | |
| Ownership type | <0.001 | |||||||
| National/Public | 11 (27.5) | 47 (23.2) | 58 | - | 5 (6.5) | 4 (7.5) | 9 | |
| Social welfare/Special foundation | 1 (2.5) | 5 (2.0) | 6 | 1 (16.7) | 3 (3.9) | 2 (3.8) | 6 | |
| Medical | 2 (5.0) | 102 (50.2) | 104 | - | 58 (75.3) | 40 (75.5) | 98 | |
| Private | 1 (2.5) | 18 (8.9) | 19 | - | 5 (6.5) | 7 (13.2) | 12 | |
| Educational | 25 (62.5) | 31 (15.3) | 56 | 5 (83.3) | 6 (7.8) | - | 11 | |
| Bed capacity |
<0.010 | |||||||
| <200 | - | 20 (9.9) | 20 | - | - | 22 (41.5) | 22 | |
| 200–499 | - | 138 (68.0) | 138 | - | 19 (24.7) | 31 (58.5) | 50 | |
| 500–999 | 24 (60.0) | 44 (21.7) | 68 | - | 51 (66.2) | - | 51 | |
| 1000–1999 | 13 (32.5) | 1 (0.5) | 14 | 6 (100) | 7 (9.1) | - | 13 | |
| ≥2000 | 3 (7.5) | - | 3 | - | - | - | 0 | |
| Proportion of resident physicians (%) |
<0.001 | |||||||
| <10 | - | 147 (72.4) | 147 | - | 62 (80.5) | 53 (100) | 115 | |
| 10–19 | 1 (2.5) | 23 (11.3) | 24 | 5 (83.3) | 15 (19.5) | - | 20 | |
| 20–29 | 7 (17.5) | 20 (9.9) | 27 | 1 (16.7) | - | - | 1 | |
| ≥30 | 32 (80.0) | 13 (6.4) | 45 | - | - | - | 0 | |
| Total | 40 (100) | 203 (100) | 243 | 6 (100) | 77 (100) | 53 (100) | 136 | |
| Subgroup | n | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 |
|---|---|---|---|---|---|---|---|---|
| Total | 243 | 1.72±8.50 | 0.73±8.77 | 0.65±9.22 | 0.78±8.97 | −10.62±27.78 | −6.29±23.69 | −9.45±32.24 |
| Classification | ||||||||
| Tertiary | 40 | 4.18±5.91 | 4.35±5.67 | 3.92±5.16 | 4.33±5.23 | 0.66±6.36 | 2.84±5.98 | 1.68±5.90 |
| Secondary | 203 | 1.24±8.85 | 0.01±9.10 | 0.01±9.70 | 0.08±9.38 | −12.84±29.78 | −8.08±25.41 | −11.64±34.77 |
| Location | ||||||||
| Capital region | 103 | 1.19±9.63 | 0.00±9.48 | −0.84±10.85 | −0.15±10.37 | −14.34±37.13 | −7.27±28.38 | −13.80±44.39 |
| Non-capital region | 140 | 2.12±7.58 | 1.26±8.20 | 1.75±7.66 | 1.47±7.75 | −7.88±17.72 | −5.56±19.62 | −6.25±18.42 |
| Ownership | ||||||||
| National/Public | 58 | −6.61±9.84 | −8.35±10.02 | −8.28±12.08 | −8.57±10.88 | −39.64±44.57 | −29.52±31.63 | −38.60±47.38 |
| Social welfare/Special foundation | 6 | −2.13±5.65 | −3.23±3.29 | −2.29±3.98 | −2.39±4.02 | −7.81±6.37 | −5.62±4.01 | −7.22±7.48 |
| Medical corporation | 104 | 4.94±5.37 | 3.61±5.46 | 3.91±5.50 | 4.30±5.21 | −1.12±7.36 | 0.98±18.25 | 0.05±22.89 |
| Private foundation | 19 | 1.40±5.25 | 0.97±5.53 | 1.10±5.03 | 1.63±4.59 | −3.59±4.96 | 0.21±5.36 | −0.09±5.98 |
| Educational foundation | 56 | 4.91±6.85 | 5.11±6.60 | 4.02±6.31 | 3.98±6.68 | −0.90±7.14 | 2.01±6.66 | −0.33±8.16 |
| Bed capacity | ||||||||
| <200 | 20 | −1.19±9.04 | −3.49±10.75 | −4.51±14.39 | −3.82±12.05 | −21.31±42.65 | −13.40±24.38 | −13.91±26.79 |
| 200–499 | 138 | 1.00±8.43 | −0.21±8.85 | 0.28±9.10 | 0.16±9.12 | −12.69±29.04 | −8.42±27.80 | −12.64±39.10 |
| 500–999 | 68 | 3.83±8.61 | 3.33±7.96 | 2.44±7.87 | 2.79±7.85 | −5.90±21.12 | −1.84±14.50 | −4.18±18.28 |
| 1000–1999 | 14 | 2.71±6.79 | 3.11±5.26 | 2.84±4.51 | 3.79±4.71 | −0.19±6.16 | 1.23±6.21 | −0.27±6.57 |
| ≥2000 | 3 | 1.85±5.64 | 1.80±5.68 | 1.77±4.18 | 0.46±2.56 | 0.02±2.78 | 3.61±2.77 | 4.73±2.25 |
| Proportion of resident physicians (%) | ||||||||
| <10 | 147 | 1.32±8.21 | −0.31±9.03 | 0.03±9.59 | 0.15±9.19 | −13.08±30.43 | −8.19±26.67 | −11.28±37.35 |
| 10–19 | 24 | −0.19±7.02 | −0.35±5.87 | −0.71±6.32 | −0.35±6.61 | −14.03±28.45 | −10.68±23.23 | −17.29±29.62 |
| 20–29 | 27 | 2.19±10.04 | 2.85±9.13 | 1.38±11.07 | 1.12±11.59 | −8.54±27.36 | −3.39±21.40 | −6.27±24.42 |
| ≥30 | 45 | 3.77±9.03 | 3.41±8.40 | 2.99±7.81 | 3.24±7.19 | −2.02±14.20 | 0.54±9.92 | −1.21±12.46 |
| Variables | n | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 |
|---|---|---|---|---|---|---|---|---|
| Total | 243 | 8.55±14.17 | 7.37±14.94 | 7.87±14.28 | 8.90±16.64 | 2.56±17.11 | 25.39±80.87 | 21.09±48.47 |
| Classification | ||||||||
| Tertiary | 40 | 17.26±19.35 | 18.53±20.78 | 17.88±19.09 | 21.06±22.31 | 14.06±23.40 | 39.29±36.34 | 37.33±24.86 |
| Secondary | 203 | 6.83±12.26 | 5.17±12.43 | 5.90±12.25 | 6.51±14.17 | 0.29±14.62 | 22.65±86.80 | 17.89±51.31 |
| Location | ||||||||
| Capital region | 103 | 10.14±15.44 | 7.98±16.56 | 7.84±15.29 | 10.04±19.00 | 2.70±20.65 | 37.93±121.20 | 32.24±70.24 |
| Non-capital region | 140 | 7.37±13.09 | 6.92±13.67 | 7.89±13.55 | 8.06±14.68 | 2.45±14.02 | 16.16±20.11 | 12.89±17.61 |
| Ownership | ||||||||
| National/Public | 58 | 2.93±11.00 | 0.76±10.33 | 2.76±10.11 | 1.83±9.79 | 1.15±17.91 | 53.71±157.48 | 8.43±19.26 |
| Social welfare/Special foundation | 6 | 1.05±11.27 | −3.72±14.06 | 0.37±8.79 | 0.81±9.46 | −1.27±11.88 | 4.22±9.41 | 5.93±20.29 |
| Medical corporation | 104 | 7.56±10.57 | 6.04±10.90 | 6.53±11.12 | 8.92±13.90 | 0.99±13.76 | 14.19±23.92 | 30.85±67.90 |
| Private foundation | 19 | 6.73±10.97 | 6.08±10.65 | 7.59±10.49 | 8.29±11.02 | −0.56±8.24 | 8.17±12.11 | 12.75±15.39 |
| Educational foundation | 56 | 17.61±19.29 | 18.3±20.22 | 16.55±20.07 | 17.26±24.05 | 8.40±22.79 | 24.96±26.68 | 20.56±28.40 |
| Bed capacity | ||||||||
| <200 | 20 | 4.81±11.55 | 1.95±11.12 | 3.53±13.35 | 2.24±20.38 | −4.72±16.93 | 15.34±29.83 | 2.09±17.01 |
| 200–499 | 138 | 4.99±9.31 | 3.35±10.19 | 5.16±10.11 | 5.46±10.93 | 0.76±14.01 | 17.23±24.97 | 23.37±60.20 |
| 500–999 | 68 | 15.50±17.73 | 15.10±17.86 | 13.06±18.38 | 16.03±21.00 | 6.50±19.66 | 41.04±145.17 | 18.28±25.54 |
| 1000–1999 | 14 | 12.65±19.43 | 15.07±18.71 | 12.53±15.28 | 15.96±20.45 | 6.74±23.75 | 39.25±50.83 | 30.47±23.58 |
| ≥2000 | 3 | 20.20±33.71 | 16.87±42.03 | 22.15±32.77 | 16.98±21.46 | 24.67±22.26 | 48.02±35.35 | 63.09±18.22 |
| Proportion of resident physicians (%) | ||||||||
| <10 | 147 | 5.44±8.87 | 3.31±9.35 | 4.90±9.81 | 5.38±11.70 | 0.06±13.27 | 17.75±25.80 | 19.86±50.15 |
| 10–19 | 24 | 6.74±14.35 | 4.34±13.50 | 4.59±15.33 | 5.75±18.15 | 0.16±20.65 | 11.52±23.95 | 16.00±80.66 |
| 20–29 | 27 | 14.38±17.30 | 17.84±16.43 | 12.97±16.03 | 15.50±23.94 | 5.65±21.46 | 25.30±24.64 | 17.44±29.92 |
| ≥30 | 45 | 16.17±21.09 | 15.94±21.91 | 16.27±20.11 | 18.13±19.94 | 10.13±21.03 | 57.78±178.12 | 30.03±23.20 |
| Variable of interest | Medical revenue-to-profit ratio (%) | Net income before reserve fund allocation per 100 beds |
|---|---|---|
| Model 1 (effect of time) | ||
| Year | −1.33 (−2.07, −0.59) | −0.89 (−2.75, 0.97) |
| COVID-19 | −1.55 (−2.86, −0.23) | 6.67 (3.36, 9.97) |
| Model 2 (effect of COVID-19) | ||
| Classification | ||
| Tertiary hospital | Reference | Reference |
| Secondary hospital | −1.90 (−7.27, 3.47) | −1.50 (−11.33, 8.34) |
| Region | ||
| Capital region | Reference | Reference |
| Non-capital region | 4.16 (1.28, 7.04) | 2.32 (−3.10, 7.74) |
| Ownership | ||
| National/Public | Reference | Reference |
| Social welfare/Special foundation | 6.77 (−2.37, 15.91) | −5.05 (−22.28, 12.19) |
| Medical | 16.40 (12.80, 20.00) | 4.73 (−2.05, 11.51) |
| Private | 11.05 (5.36, 16.74) | 2.58 (−8.15, 13.31) |
| Educational | 13.77 (9.41, 18.13) | 8.92 (0.75, 17.10) |
Values are presented as number (%). Nursing hospital or psychiatric hospital. Based on 2022 data.
Values are presented as mean±standard deviation.
Values are presented as mean±standard deviation. KRW, Korean won.
Values are presented as coefficient (95% confidence interval). Unit: billion Korean won.