Structure, function, and impact of hospital accreditation in South Korea: a narrative review

Background and Objective: Hospital accreditation is globally recognized to enhance patient safety and healthcare quality. South Korea, despite having the highest number of hospital beds per capita among Organization for Economic Cooperation and Development (OECD) countries, faces challenges due to a low proportion of public beds. To address the need for standardized hospital operations and facilities, South Korea has implemented its hospital accreditation system. This study aims to review previous literature on hospital accreditation in South Korea to examine the structure, functions, outcomes of this systems and its challenges. Methods: A narrative review was conducted using databases such as PubMed, Web of Science, Google Scholar, Korea Citation Index (KCI), and DBpia, focusing on publications since 2017. Additional data on accreditation standards, procedures and results were obtained from the Korea Institute for Healthcare Accreditation (KOIHA). A comprehensive analysis was performed to synthesize findings from both academic literature and institutional resources. Key Content and Findings: The accreditation system in South Korea evaluates hospitals across four domains: fundamental value system, patient care system, organizational management system, and performance management system. Accreditation is mandatory for long-term care hospitals. Other hospitals may opt for accreditation voluntarily; however, institutions operating tertiary hospitals and specialized hospitals are required to obtain accreditation periodically. Accredited hospitals demonstrated higher quality of care and improved financial performance compared to non-accredited hospitals. However, challenges such as temporary staffing adjustments during evaluations and the administrative burden of maintaining accreditation standards were noted. Conclusions: The accreditation system has contributed to the standardization and enhancement of healthcare quality in tertiary hospitals in South Korea. Further research is necessary to refine staffing standards and address the sustainability of accreditation practices to ensure the continued advancement of patient safety and healthcare quality.