Investigating Healthcare Management System and its Stakeholders: A Case Study of Korea’s MERS Outbreak

Abstract

Recently, there is a worldwide increase in the epidemic disease outbreaks. Whenever these emergencies happen, they challenge the health systems and their procedures. Many of the established systems fail in the process and precious time is lost while trying to contain the diseases. In 2015, it took more than two months to contain Middle East Respiratory Syndrome outbreak in Korea. Considering the fact that Korea’s geographical location allows travel abroad only by air or sea, control of a Middle East origin disease outbreak should have been easier. However, examination during the outbreak period shows that the country was not prepared for emergency management especially in terms of healthcare management culture. In this study, we present problems and difficulties Korean healthcare organizations confronted during the outbreak and critically review management of Korean healthcare organizations from stakeholder theory’s point of view. By taking one of the biggest hospitals in Korea as a representative case, it can be seen that Korean healthcare organizations do not fulfill accountabilities toward their stakeholders and it led the whole country into chaos both socially and economically. Analysis of the case shows that Korean healthcare organizations’ great focus on financial profit and their corporate structures caused a failure in protecting the hospitals’ main ethical priority: patients’ welfare. Failures of the system show that evaluations of healthcare organization should be solely based on healthcare quality provided by the organization, not by the name value of any related corporations.

Keywords

• Korean healthcare system,Korean healthcare organization management,Healthcare ethics,Middle East Respiratory syndrome

References

1. Ahn, J. J., & Kim, Y. S. (2015, September 10). 대형병원 외래진료 10년간 161% 급증…메르스 사태 ‘뇌관’ [Outpatient treatment of big hospitals increased 161% during 10 years… working as detonator of MERS outbreak]. MoneyToday. Retrieved from http://www.mt.co.kr/view/mtview.php?type=1&no=2015091012242134640&outlink=1
2. Ahn, S. (2015, June 17). 문제는 낙타가 아니다 [Camel is not the problem]. Gimhaenews. Retrieved from http://www.gimhaenews.co.kr/news/articleView.html?idxno=12906
3. Brugha, R., & Varvasovszky, Z. (2000). Stakeholder analysis: a review. Health Policy and Planning, 15(3), 239-246.
4. Capron, A. M. (2007). Ethical considerations in international preparedness planning efforts. In Ethical and Legal Considerations in Mitigating Pandemic Disease: Workshop Summary.
5. Centers for Disease Control and Prevention. (2014). Ebola (Ebola Virus Disease). Retrieved from https://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/united-states-imported-case.html
6. Choe, S. (2015, June 17). South Korean hospital scrutinized in MERS outbreak. The New York Times. Retrieved from http://www.nytimes.com/2015/06/18/world/asia/south-korean-hospital-scrutinized-in-mers-outbreak.html?_r=1
7. Choe, S. (2017, April 17). Park Geun-hye, ousted president of South Korea, is formally indicted. The New York Times. Retrieved from https://www.nytimes.com/2017/04/17/world/asia/park-geun-hye-south-korea-president-indictment.html?mcubz=2&_r=0
8. Choi, E. K. (2015, March 16). 과밀한 응급실, 보건복지부 전국 응급의료기관 평가결과 발표 [Ministry of Health and Welfare announced the result of evaluation of emergency medical institutions]. HiDoc. Retrieved from http://www.hidoc.co.kr/news/healthtoday/item/C0000098203

9. Donaldson, T., & Preston, L. E. (1995). The stakeholder theory of the corporation: Concepts, evidence, and implications. Academy of Management Review, 20(1), 65-91.
10. Emanuel, E. J., & Emanuel, L. L. (1996). What is accountability in health care?. Annals of internal medicine, 124(2), 229-239.
11. Emanuel, L. L. (2000). Ethics and the structures of healthcare. Cambridge Quarterly of Healthcare Ethics, 9(2), 151-168.
12. Freeman, R. E. (1994). The politics of stakeholder theory: Some future directions. Business Ethics Quarterly, 4(4), 409-421.
13. Freeman, R. E. (2004). The stakeholder approach revisited. Zeitschrift für Wirtschafts-und Unternehmensethik, 5(3), 228-241.
14. Freeman, R. E, Wicks, A. C., & Parmar, B. (2004). Stakeholder theory and “the corporate objective revisited”. Organization Science, 15(3), 364-369.
15. Freeman, R. E., Harrison, J. S., Wicks, A. C., Parmar, B. L., & De Colle, S. (2010). Stakeholder theory: The state of the art. New York: Cambridge University Press.
16. Garvare, R., & Johansson, P. (2010). Management for sustainability–a stakeholder theory. Total Quality Management, 21(7), 737-744.
17. Health Insurance Review & Assessment Service. (2015). Retrieved on January 18, 2016 from http://www.hira.or.kr/main.do
18. Holmboe, E. S., Edgar, L., & Hamstra, S. (2016). The milestones guidebook. Accreditation Council for Graduate Medical Education. Retrieved from http://www.acgme.org/
19. Jeon, H. W. (2015, June 9). ‘허당 매뉴얼’ 구멍이 숭숭 [Sloppy manual]. Sisainlive. Retrieved from http://www.sisainlive.com/news/articleView.html?idxno=23517
20. Jeon, J., & Im, I. (2015, June 14). ‘삼성의 자만’과 ‘정부의 오판’ 이 메르스 사태 키웠다 [Excessive pride of Samsung and misjudgment of government worsened the MERS outbreak]. The Hankyoreh. Retrieved from http://www.hani.co.kr/arti/society/health/695895.html?_fr=mt2
21. Jun, B. (2015). Middle East Respiratory Syndrome outbreak and infectious disease control in Korea. Journal of the Korean Medical Association, 58(7), 590-593.
22. Jung, M. (2015, June 15). Hubris jinxes Samsung Medical Center. The Korea Times. Retrieved from http://www.koreatimes.co.kr/www/news/opinon/2015/12/264_180917.html
23. Kang, M. S. (2015, June 30). 일류, 명품 삼성병원은 왜 뚫렸나? [Why first-class Samsung Medical Center was penetrated?]. OhmyNews. Retrieved from http://www.ohmynews.com/NWS_Web/View/at_pg.aspx?CNTN_CD=A0002123090
24. Kim, K. (2013). Hospital Business. Seoul: hanibook.
25. Kim, K. H., Lee, J. C., Seo, K. H., Kim, S. Y., & Lee, J. S. (2015). Analysis and improvement of health care delivery system. (Working Paper). Research Institute for Healthcare Policy.
26. Kim, K. M., Ki, M., Cho, S. I., Sung, M., Hong, J. K., Cheong, H. K., ... & Park, Y. S. (2015). Epidemiologic features of the first MERS outbreak in Korea: focus on Pyeongtaek St. Mary’s Hospital. Epidemiology and Health, 37, 1-10.
27. Kim, M. S. (2015, December 12). 삼성서울병원 메르스 손실 무려 ‘1600억 +@’설 [It is claimed that loss of Samsung Medical Center from MERS is more than 160 billion won]. Dailymedi. Retrieved from http://dailymedi.com/detail.php?number=801303
28. Kim, Y. (2015a). Future agenda for emergency medical service in Korea: from silos to systems. Journal of the Korean Medical Association, 58(9), 776-779.
29. Kim, Y. (2015b). Healthcare policy and healthcare utilization behavior to improve hospital infection control after the Middle East respiratory syndrome outbreak. Journal of Korean Medical Association, 58(7), 598-605.
30. Korea Centers for Disease Control and Prevention. (2015a). Middle East Respiratory Syndrome coronavirus outbreak in the Republic of Korea, 2015. Osong Public Health and Research Perspective, 6(4), 269-278.
31. Korea Centers for Disease Control and Prevention. (2015b). Middle East Respiratory Syndrome Information. Retrieved on January 5, 2016 from http://www.mers.go.kr/mers/html/jsp/main.jsp
32. Korean Medical Association (2015, December). Korean Medical Association Correspondence Data related with MERS Outbreak (Sourcebook No. 22). Seoul: Author.
33. Lee, J. S. (2015, June 15). 삼성서울병원, 메르스 관리 실패 ‘불명예’ [Samsung Medical Center failed to manage MERS outbreak]. NEWSPIM. Retrieved from http://www.newspim. com/news/view/20150615000157
34. Lee, S. W. (2015. September 4). 대형병원들, 최근 10년간 외래진료 늘려서 생존했다 [Big hospitals have been surviving through increasing outpatients in recent 10 years]. Rapportian. Retrieved from http://www.rapportian.com/n_news/news/view.html?no=23759
35. Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centered access to health care: conceptualising access at the interface of health systems and populations. International Journal for Equity in Health, 12(1), 1-9.
36. Ministry of Government Legislation. (2015). Retrieved from http://www.law.go.kr/main.html
37. More foreigners cancel trips to S. Korea over MERS outbreak. (2015, June 7). Retrieved November 23, 2015 from http://english.yonhapnews.co.kr/search1/2603000000.html?cid=AEN20150607000400320
38. Organization for Economic Co-operation and Development. (2013). Doctors (overall number). In Health at a Glance 2013: OECD Indicators (pp. 64-65). Paris, OECD Publishing.
39. Organization for Economic Co-operation and Development. (2015). Nurses. In Health at a Glance 2015: OECD Indicators (pp. 90-91). Paris, OECD Publishing. Doi. http://dx.doi.org/10.1787/health_glance-2015-26-en
40. Park, E. C. (2015). Central government reform to improve national disease control. Journal of the Korean Medical Association, 58(8), 714-722.
41. Park, Y. S., Lee, C., Kim, K. M., Kim, S. W., Lee, K. J., Ahn, J., & Ki, M. (2015). The first case of the 2015 Korean Middle East Respiratory Syndrome outbreak. Epidemiology and Health, 37, 1-5.
42. Salmon, A. (2015, June 12). Seoul a ghost town as South Korea grapples with Mers fear. The Telegraph. Retrieved from http://www.telegraph.co.uk/news/worldnews/asia/southkorea/11671963/Seoul-a-ghost-town-as-South-Korea-grapples-with-Mers-fear.html
43. Smith, K. F., Goldberg, M., Rosenthal, S., Carlson, L., Chen, J., Chen, C., & Ramachandran, S. (2014). Global rise in human infectious disease outbreaks. Journal of the Royal Society Interface, 11(101), 20140950.
44. Song, T. (2015). Social big data and its application: with special reference to MERS information diffusion and risk prediction. Health and Welfare Policy Forum, 227, 29-49.
45. Stieb, J. A. (2009). Assessing Freeman’s stakeholder theory. Journal of Business Ethics, 87(3), 401-414.
46. The Bank of Korea. (2015). 통화정책방향 [Direction of Monetary Policy]. [Press Release]. Retrieved from www.bok.or.kr
47. The Board of Audit and Inspection of Korea. (2016). Audit result announcement of prevention and response toward MERS. [Press release]. Retrieved from http://www.bai.go.kr/bai/index.do
48. The Joint Commission. (2010). Advancing effective communication, cultural competence, and patient-and family-centered care: A roadmap for hospitals. Oak Terrace, IL: The Joint Commission.
49. The Ministry of Culture, Sports and Tourism. (2015). 메르스 관련 관광진흥개발기금 운영자금 특별융자지원 지침 [Guidelines of MERS related special loan for supporting operational fund of tourist business] (Report No. 2015-0118). Retrieved from www.mcst.go.kr
50. Tourism industry suffers 3.4 tln won loss from MERS outbreak: report. (2015, November 6). Retrieved November 23, 2015 from http://english.yonhapnews.co.kr/business/2015/11/06/25/0501000000AEN20151106002500320F.html
51. Werhane, P. H. (2000). Business ethics, stakeholder theory, and the ethics of healthcare organizations. Cambridge Quarterly of Healthcare Ethics, 9(2), 169-181.
52. Winkler, E. C., & Gruen, R. L. (2005). First principles: substantive ethics for healthcare organizations. Journal of Healthcare Management, 50(2), 109-119
53. World Health Organization. (2015). Middle East respiratory syndrome coronavirus (MERS-CoV) [Fact sheet]. Retrieved from http://www.who.int/mediacentre/factsheets/mers-cov/en/
54. World Health Organization (2016a). Ebola Situation Report. Retrieved from http://apps.who.int/ebola/current-situation/ebola-situation-report-30-march-2016
55. World Health Organization (2016b). Zika virus [Fact sheet]. Retrieved from http://www.who.int/mediacentre/factsheets/zika/en/
56. Yoo, S., & Lee, S. M. (1987). Management style and practice of Korean chaebols. California Management Review, 29(4), 95-110.