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A Study on Medical Treatment in the Korean Correctional Facilities

  • Kwon, Soo-jin, Han, Min-kyung, Kwon, Chang-mo, Choo, Young-soo   |   2017
  • Friday, October 19, 2018
  • Hits : 43

The problems of the medical treatment in the Korean correctional facilities are mostly caused by an increase in the number of inmates and inmate patients, the shortage of medical staffs, and inadequate medical facilities. These issues have existed throughout the history of correctional facilities. Thus, this study investigates the current medical treatment in Korean correctional facilities for its overall improvement and the environment for its inmates.


For this purpose, researchers visited over 26 correctional facilities across Korea for five months from June to October 2017 and surveyed 2,089 inmates to examine the actual condition of medical treatment in Korean correctional facilities. Also, in-depth interviews from 88 inmates and medical staffs, primarily physicians, were conducted for the overall understanding of correctional facilities and considered various aspects to improve its medical treatment, environment, and system. Furthermore, an online survey of 2,007 people asked questions to figure out the public awareness and compare their responses with the perception of the inmates. Lastly, a comparative study on the medical treatment at overseas correctional facilities was conducted by collecting related-data through online and offline means and inquired information regarding corrections, the justice departments, and correctional facilities in foreign countries.


Based on the results, this study proposes the following to overcome the current limitations of medical treatment in Korean correctional facilities and increase the number of opportunities for its inmates to receive better medical treatment:


1. The Expansion of Specialized Correctional Institutions for Medical Treatment


The best way to improve medical treatment in correctional facilities is to build a general, hospital-scaled medical institute for inmates in correctional facilities across the country. For this, however, a significant increase in correctional facilities' budget and personnel are required to establish and operate the proposed hospital. Therefore, a long-term discussion and preparation are necessary for its establishment.


Regarding the alternative establishment of the specialized hospital, it could be an option to open a correctional ward in a public or private medical institute. In other words, a public medical institute could have a separate building/floor for a correctional ward to take care of the inmate patients from correctional facilities. In this case, inmate patients can receive professional medical services while correctional facilities can save funds on their workforce, which could be applied for its medical care. Also, the public medical institute can make profits regularly and reduce debt with the patients from the Ministry of Justice.


In addition, correctional facilities and the regional correctional departments need to promote exchanges with regional doctoral associations, advertise the publicity of medical care in correctional buildings, and expand partnered medical institutes by signing an MOU with public medical institutes under the Ministry of Justice. As well, to promote an invited medical exam and telemedicine as an alternative to medical care in correctional facilities is required, if there is a plan to prevent any side effects of telemedicine such as a drug overdose before its implementation.


2. The Improvement of Hospital Environments


In reality, resolving prison overcrowding is the most important priority to keep patients free from accidents, mental health, and infection. Therefore, the size of living space which at least ensures the minimum quality of life for inmates ought to be stipulated first. Then, the quota of current correctional facilities should be reset and adjusted by increasing the parole, suspension of punishment, and investigation without detention.


In the aspects of medical treatment, it is essential to provide sufficient water for cooling and heating and bathing to protect the inmates’ human rights and keep them safe from infectious diseases in the summer. Furthermore, treatment and examination rooms in women's ward and a solitary room for the isolated treatment of infectious diseases such as T.B. are required. Notably, it is desirable to open additional hemodialysis units for non-convicted prisoners and accommodate them in the correctional facilities which have hemodialysis units. In addition, outdated medical equipment such as an X-ray system should be replaced with new ones to have patients receive medical exams at the correctional institutions.


3.    Building a Public Health Care System for the Correctional Facilities


It is necessary to have a medical administrative control tower for correctional facilities, which differs from prison administration in the Ministry of Justice. Also, it could be considered to invite professional medical staff to the Policy Advisory Council in the Ministry of Justice, and receive advisory and assessment services on the medical treatment policies of correctional facilities.


Furthermore, the establishments of cancer and significant disease management system and an emergency medical service system in the correctional facilities in close cooperation with related agencies and regional medical institutions should be established. For this, an effective plan could be developed through a legislative method which requires a written consent when an inmate is imprisoned and a computer system which is connected to the BORAMI system and the National Health Insurance Service system.


4.    Securing Medical Staff


For the securement of medical staff in correctional facilities, their salary, which is significantly lower than private hospitals, should be reviewed to ensure a reasonable compensation. Considering the unique and particular aspects of the public health care for inmate patients, furthermore, the salary of medical staffs in correctional facilities should be increased to a reasonable level and include overnight and holiday pay and special medical examination benefits.


Also, it is necessary to offer a scholarship to medical school students and establish an internal scholarship program in the correctional facilities for the recruitment of qualified medical staff. Additionally, promoting exchanges with regional medical staff, such as the regional doctors association, and creating ads to secure medical staff employment for correctional facilities are beneficial. Paramedical staffs such as nurses, radiologic technologists, and emergency medical technicians should be secured, too.


5. The Reinforcement of Medical Staff’s Competence


There is a demand for a legal support system which can prevent and properly respond to inmates’ appeals and complaints relating to the medical treatment in correctional facilities. The Ministry of Justice needs to introduce the Practitioners Malpractice and General Liability Insurance coupled with the Doctors Benefit Association or private insurance company to mitigate a medical staff’s burden of malpractice. It is also desirable to offer more opportunities to receive medical technology and information through regular maintenance training, workshops, and field trips to advanced correctional facilities.


6.    The Rationalization of Medical Treatment for Inmate Patients


Regarding inmates’ external medical examination costs, the payment rule on applying the expenses of the government and one’s own should be clarified with the standards according to the National Health Insurance rates and the medical benefit recipient criteria. Also, the types of drugs provided by correctional facilities need to be increased, and the regulations on first-aid medicine such as pain relief pills should be mitigated for the rationalization of inmate patients’ medical treatment. Furthermore, it is required to provide patient meals and expand mental health programs for the benefits of correctional facility inmates.


7. Improved Awareness on Medical Treatment in Correctional Facilities


The trust between medical staff and inmates should be the base to improve the medical treatment in correctional facilities and provide a better understanding between the medical and non-medical staff. Furthermore, the perception of the general public on medical treatment in correctional facilities should be changed as awareness increases on the public medical treatment, and it is necessary to take countermeasures on the pan-government

Keyword Korean Correctional Facilities, Medical Treatment