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Key Takeaways
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As South Korea’s physician shortage intensified, the government turned to grants and higher delivery reimbursements to preserve obstetric care. A study from George Mason is the first nationwide analysis of whether those financial incentives worked.
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The study found that while incentives shifted staffing patterns, including an increase of OB/GYNs in full-time roles, they did not increase the overall number of specialists in underserved areas.
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Preserving obstetric care will require policies that go beyond payment, including workforce development, training pipelines, and quality-of-care improvements.
As South Korea’s physician shortage has intensified, the government has leaned on targeted grants and financial incentives to preserve essential services, particularly obstetric care. Yet despite sustained investment, many rural communities still struggle to keep their maternity units alive.
A new study led by health policy researcher Hansoo Ko of the George Mason College of Public Health, in collaboration with colleagues across South Korea, offers the clearest picture yet of why these efforts have fallen short. It’s the first nationwide analysis to track whether South Korea’s financial incentive programs have tangibly increased the number of OB/GYN specialists in underserved areas.
“The physician shortage has reached a boiling point,” Ko said. The South Korean government, he explained, initially proposed a dramatic expansion of medical school quotas, but backlash from physicians—culminating in a prolonged strike—only further strained the already-fragile health care system.
In their response to that unrest, policymakers doubled down on financial solutions. For the maternal care shortage, they rolled out two major forms of support: early grants to build and operate OB/GYN units, followed by sharply higher reimbursement rates for deliveries. Ko and his team set out to track whether those incentives worked as intended, analyzing 10 years of administrative claims data from 240 cities across South Korea.
“We found that while the incentives reshaped staffing patterns, they didn’t solve the shortage,” Ko said.
Study findings
When the government increased reimbursement rates in 2016:
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Full-time OB/GYN staffing ticked up, suggesting that better payments helped hospitals convert part-time roles into more secure, full-time jobs.
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Part-time staffing dropped sharply, enough to create an overall net decline in the number of OB/GYN specialists.
South Korea’s record-low fertility rate compounds the public health challenge. Ko and his colleagues say future solutions need to reach beyond financial subsidies—including workforce development, training pipelines, and quality-of-care improvements—to ensure rural communities don’t lose the little obstetric care they have left.
About the researcher
Ko is an assistant professor, public health physician, and health services researcher specializing in health economics and policy, with a focus on behavioral responses and insurance markets.