South Korea
South Korea’s healthcare system in a nutshell
Funding
The healthcare system in South Korea is a nationally-run single-payer model, managed by the National Health Insurance Service (NHIS). The NHIS oversees allocation of funding, which comes from payroll taxes, government subsidies, and ‘sin taxes’, which largely come from taxation on tobacco sales. South Korean citizens and residents of more than six months who are employed contribute around 7% of their salary, shared between the employer and the employee, to the NHIS fund, up to a total of around $6000 per month. Those who are self-employed make NHIS contributions based on their income and assets. NHIS contributions are mandatory and cover over 80% of the funding for NHIS, with the remaining 20% coming from government subsidies and sin taxes.
South Korea has universal healthcare coverage, with around 97% of the population covered by NHIS and the remaining 3% covered by the government medical aid programme. Patients are also required to make co-payments when they receive hospital care, ranging from 5% for treatment of severe disease, to 20% for in-patient hospital stays, to up to 60% for some outpatient visits. The larger co-payments are due to a ‘mild disease penalty’, which is designed to discourage the use of medical facilities that are beyond what the person needs to treat mild diseases and illnesses. These co-payments are subject to an annual cap of between $1200 and $3500 annually, dependent on income, but do mean that much of the population also purchases ‘actual loss’ (Silbi) insurance, which covers much of the out-of-pocket costs paid by patients when they receive healthcare treatment.
NHIS uses funding allocation and decisions around coverage to affect decision-making by patients and by healthcare providers. Patients are responsible for larger co-payments for using more healthcare than they need for mild treatments, whilst healthcare providers are penalised for over-pricing or over-administering certain treatments. In 2026, the NHIS began covering ‘manual therapy’ with a copayment of 95% for the patient. This was in response to concerns that the treatment was being over-used by patients and over-administered by healthcare providers. Since it is now a treatment that is covered by NHIS, it is subject to a maximum cost and maximum frequency. If either the maximum cost or frequency are exceeded, the treatment is no longer covered by NHIS, meaning patients are incentivised to choose providers who do not exceed the maximums.
Public vs private
Whilst South Korea has universal coverage and a publicly-funded, single-payer model, the provision of healthcare in the country is overwhelmingly by the private sector. Around 95% of hospitals and healthcare institutions and 90% of hospital beds in South Korea are private and owned by individuals, corporations or private universities. The remaining 5% are publicly-owned and are responsible for provision of healthcare for patients who are not insured by NHIS.
In 2020, public funding (including via NHIS) accounted for 64.4% of healthcare spending in South Korea, with the remaining 35.6% representing out of pocket expenditure by the population.
The National PHR
History
The funding and structure of South Korea’s healthcare system contribute to the current state of data availability and PHR adoption in the country. The single-payer model means that NHIS has a large, rich dataset of claims, administrative and activity data at a national level, which has been and continues to be used for longitudinal research studies into how healthcare is used and the prevalence of disease. Furthermore, EHR usage in hospitals is universal and happened early, as this was a requirement for the hospitals to be able to submit claims to NHIS. Healthcare is largely provided by the private sector and is largely delivered in hospitals, with South Korea having triple the OECD average hospital beds per 1,000 people (12.6 vs 4.2) and more than double the average length of hospital stay (17.1 days vs 8.1 days). Since these hospitals are all owned and operated by private entities, the clinical data generated in them are often stored in separate and sometimes proprietary EHR systems. A result of this is that the such clinical data, for example test results, outcomes, and patient-generated data, are not integrated into a national repository.
A 2022 OECD report identified Korea as a strong candidate for the development of a nationally integrated patient health record. One reason for this was the existence of a single identifier, the Resident Registration Number (RRN), which can be used for record linkage between 90% of clinical systems in the country. However, the lack of interoperability between these systems mean that sharing data between them, or integrating them into a national personal health record, is difficult. The Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) has been introduced to try to standardise the data held by hospital EHRs. Whilst this makes secondary uses of healthcare data easier, a CDM is not a practical solution for real-time sharing of healthcare data between EHR systems, or for the development of a PHR, because the data remains in different, non-interoperable formats at source and is only converted to the common data model after a period of time.
EHR standardisation and certification is a tool used by many countries to encourage healthcare providers to use interoperable systems. Whilst Korea does certify EHR systems, there are no incentives or penalties to encourage healthcare providers to use interoperable systems developed by certified vendors.
Data standards
Between 2010 and 2020, the Korea Standard Terminology of Medicine (KOSTOM) was the national data standard in South Korea. However, its use was optional and its adoption was poor. By 2020, the adoption of standardised forms of data storage such clinical document (CDA) and FHIR were poor, at 21% and 10% respectively. EHR standardisation is a national target and, in 2022, the Health Data Standardization Taskforce was formed and included members from the government and the private sector. In 2023, it published the Korea Core Data for Interoperability (KR CDI) and the Korea Core Data Transmission Standard (HL7 FHIR KR Core). The primary implementation of HL7 FHIR KR Core is the My HealthWay personal health record application, but the adoption of the standard has led to efforts in South Korea to convert heterogeneous EHR data into FHIR.
My HealthWay
Background
The My HealthWay project was launched in 2021 and initially intended to share data with patients via a personal health record, including medical records, laboratory test and medical image results, insurance claims, patient contributed data, and genetic data. My HealthWay is an intermediary that transfers data from various public and private healthcare providers to the patient via the ‘health information highway’, after the patient consents and submits a request using the My HealthWay application.
In late 2025, three large hospitals were cleared as ‘gatekeepers’ of My HealthWay data, which will allow them to utilise the data to develop digital tools and applications. Giving the private sector a way to become accredited to use the data in this way has opened the door to a range of applications and innovations, including:
a mental health log which combined My HealthWay data with smartphone and wearables data, which is being developed by Kangbuk Samsung Hospital
a tool to give patients information on their medications, including suggesting same-ingredient alternatives and help managing side effects, which is being developed by Kakao Healthcare
a personal health and medical data hub, which lets patients with chronic and serious diseases view their My HealthWay data alongside personalised prevention and management content, which is being developed by the Catholic Medical Centre, one of the ‘big five’ tertiary hospitals in South Korea
Usage
After a successful pilot in Seoul and Busan in 2022, the application was launched nationally in 2023. As of 2024, there were 144 medical institutions sending data to My HealthWay, including 12 tertiary hospitals, which are large general hospitals. There is currently a second phase of expansion underway, which aims to enrol the remaining 35 tertiary hospitals in the country, as well as 1300 smaller medical institutions, and register 8 million patients by the end of 2025.
Features
The My HealthWay application gives patients access to 113 discrete data types from 12 categories, including diagnoses, details of surgical procedures, medications, test results, and imaging, from hospital systems. It also gives patients one place to view information from both hospital systems, NHIS medication datasets, and general health checkups conducted by NHIS, including vaccination history and infant and toddler checkups
Korean | English | Notes |
|---|---|---|
 | | The home screen contains links for the patient to:
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| | On the ‘Public institution’ screen, patients can view their medication information, medical history, information from their health checkups, vaccination history, a summary of their medical record, as well as their recently prescribed medications. |
| | On the ‘Medical information’ screen, the patient can see a history of their medications. For each medication, they can see the dispensing pharmacy, the date of the prescription, the substance, the dose, the dose frequency, and how long they took the medication for. |
| | On the ‘Health checkup' screen, the patient can view information relating to recent health checkups, including clinical guidance from their healthcare team about relevant test results. |
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| On the ‘Health Checkup’ page, the patient can see information about general health checkups, cancer checkups conducted by the National Health Insurance Corporation in the past 10 years, and child health checkups conducted in the past 5 years, as well as questionnaire information |