Medical rehabilitation is an important and significant part of rehabilitation of persons with disability, However, many with disability in Korea do not receive proper medical rehabilitation. Although difficult to explain the reason for this phenomenon, lack of medical rehabilitation facility, skewed development of rehabilitation specialist, unrealistic reimbursement for services by the national insurance agency, deficient medical referral system along with lack of medical legislations for the disabled, meager understanding of disabled by the society and financial difficulty of the disabled are all factors that work in combination. Author will examine the core factors effecting the provision of medical rehabilitation such as medical facility, rehabilitation specialist work force and medical referral system. Together with evaluation of how the disabled are receiving medical rehabilitation, author will provide a few proposals to advance medical rehabilitation in Korea.
Currently at the end of year 2001, there are 151 tertiary and secondary hospitals (including 60 university hospitals) that have a rehabilitation department and 156 rehabilitation primary care clinics nationwide. This calculates to only 1.5% of all medical facility and indicates the deficiency of medical facility where disabled can receive specialized medical rehabilitation.
There are only 10 rehabilitation hospitals nationwide including national rehabilitation hospital with total of 920 beds, however 5 hospital or 670 beds are located within the capital.
Currently at the end of year 2000, there are 80 centers for disabled nationally (60 complex, 20 special, 6 for the mentally disabled, 7 for the blind, 2 for the deaf, 4 for physically disabled and 1 for vocational rehabilitation) with approximately half located in Seoul (29 facility,; 36.3%) and Kyungki province (9 facility; 11.3%).
At the end of year 2001, total number of rehabilitation specialist were 436 which accounts for 0.63% of 69,724 licensed physicians and 2.85 rehabilitation specialist for 10,000 disabled. Also there are within 63 hospitals (64 university affiliated hospital and 9 tertiary hospitals) 331 residents are being trained in rehabilitation currently in year 2001.
There are 17,562-licensed physical therapists currently in year 2001 with 4.2 therapists for 10,000 persons showing surplus of trained personnel. Currently in 2001, there are 1360 enrolled in twenty-three 3year colleges, 460 enrolled in eleven 4year university totaling 1820 students in 34 schools. This will lead to approximately 30,000 physical therapists by year 2010.
There are currently in year 2001, 475-licensed occupational therapist. In 2001, there are 12 (seven 3 year college and five 4 year university) schools with 565 enrolled. By the year 2006, there will be 24 universities with 925 graduating every year.
There are no law governing the requirement or licensing a speech therapist. However, Association for speech therapists did set a required training for a speech therapist and does provide an exam for certification. There are 1,238 certified speech therapist currently at the end of 2001 with 4 university and 6 graduate programs that educate speech therapist.
National licensing exam for prosto/orthosist were first given in year 2000 with 268 prosto/orthosist receiving the license. In year 2001, 153 passed the test bringing the combined total of 421-licensed prosto/orthosist in this county. Beginning 2002, there will be 3 college and 2 university providing education for 215 students.
Following are proposals for advancement of medical rehabilitation in Korea.
1. increase rehabilitation department in tertiary hospitals
2. Create secondary medical facilities
3. Create and reorganize role of center for disabled
4. Improve national insurance reimbursement policies
5. Expand activities in prevention of disability
6. Balanced production of rehabilitation specialist personnel
7. facilitate development of rehabilitation orthosis and equipment
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