{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:30:46Z","timestamp":1792099846130,"version":"4.4.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n About 52 million residents are insured under the single-payer National Health Insurance (NHI) of South Korea. Twenty-six board-certified clinical specialties practice under this system, yet specialty-level matching between physician manpower and NHI-financed workload has not been reported.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This study is an ecological cross-sectional analysis using specialty (\n n<\/jats:italic>\n \u202f=\u202f26) as the unit of observation. For 2023 and 2024, annual NHI reimbursement per specialty was divided by the mean specialist headcount to yield per-specialist reimbursement. This indicator captures facility-level resource use rather than physician effort in isolation. Specialties were placed on a reimbursement \u00d7 application-rate plane and sorted into four quadrants. Inter-specialty reallocation was simulated at 100, 70, and 50% efficiency.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Per-specialist reimbursement was 52.5 million KRW (approximately USD 40,000) in radiology (\n n<\/jats:italic>\n \u202f=\u202f4,247) and 2,668.6 million KRW (approximately USD 2.04 million) in radiation oncology (\n n<\/jats:italic>\n \u202f=\u202f330). The resulting ratio was 50.8-fold. Coefficient of variation exceeded 90% in both years. Five specialties combined above-median reimbursement with sub-100% application rates; seven showed the reverse pattern. Utilization-volume triangulation confirmed that per-specialist reimbursement was strongly correlated with claims per specialist (Spearman\n \u03c1<\/jats:italic>\n \u202f=\u202f0.74) and patients per specialist (\n \u03c1<\/jats:italic>\n \u202f=\u202f0.66), supporting its interpretation as a workload-related indicator. The rank-order association between reimbursement and application rate was not statistically detectable (\n \u03c1<\/jats:italic>\n \u202f=\u202f0.180; 95% confidence interval, \u22120.24 to 0.54;\n p<\/jats:italic>\n \u202f=\u202f0.400), and the study was underpowered for this secondary test. A counterfactual calculation, presented as an upper-bound illustration rather than a policy projection, indicated that relocating 100 specialists from lower-reimbursement to higher-reimbursement quadrants at 70% efficiency corresponded to 68.8 billion KRW in annual NHI reimbursement.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Across 2 study years, the 50.8-fold gap between these two specialties did not narrow. This dispersion, which reflects NHI-financed resource consumption rather than physician effort alone, is the principal finding. A statistically detectable link between trainee competition and NHI reimbursement was not observed; the secondary correlation test was underpowered, and its null result is not evidence of no association. These findings provide a specialty-level reimbursement baseline for South Korea\u2019s workforce allocation debate.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1878385","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:38:29Z","timestamp":1786509509000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Allocative inefficiency in physician workforce distribution: specialty-level NHI-covered reimbursement analysis in South Korea\u2019s single-payer system"],"prefix":"10.3389","volume":"14","author":[{"given":"Sun-Cheol","family":"Kim","sequence":"first","affiliation":[{"name":"Graduate School of Business, Hanyang University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Je-Il","family":"Ryu","sequence":"additional","affiliation":[{"name":"Graduate School of Business, Hanyang University","place":["Seoul, Republic of Korea"]},{"name":"Department of Neurosurgery, Hanyang University Guri Hospital, Hanyang University College of Medicine","place":["Guri, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1093\/heapol\/czn037","article-title":"Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage","volume":"24","author":"Kwon","year":"2009","journal-title":"Health Policy Plan"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"101056","DOI":"10.1016\/j.lanwpc.2024.101056","article-title":"Junior doctor strikes in South Korea: more doctors are needed?","volume":"44","year":"2024","journal-title":"Lancet Reg Health West Pac"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"105536","DOI":"10.1016\/j.healthpol.2025.105536","article-title":"South Korea\u2019s 2024 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