Background
: Primary health care institution has the important role for satisfying the national health care need primarily. In Korea, primary care has not taking the responsibility for resolving the increasing health need effectively and has been weakened. So, we intended to suggest what act as the cause of bringing the weakness of primary care and how can we solve this problem. We analyzed the characteristics of components of the charges per case among the types of health care facility for twenty common diseases in Korea.

Methods : We used Insured medical record of Federation of Korean Medical Insurance Societies from Feb. 1st to 28th of the year 1990, and we selected 16,445 cases from total 88,471,051 cases by using systemic random sampling.

Results : The charge per case was hightest in the tertiary health care institution and it was 2.9 times larger than that of primary care for the same disease. In the tertiary health care institution, the amount of cost for the oral drug was 54.3% and that for the medical examination was 17.0% of the charge per case, and compared with primary health care institution, the former was 20.6% and the latter was 4.1%, respectively. So, we found that the amount of cost for oral drug and medical examination in tertiary health care institution was greater than that of primary health care institution.

Conclusion : The charge per case of tertiary health care institution was about 3 times greater than that of primary health care institution for the same disease. In our study, we presume the higher medical cost of tertiary health care institution may be due to cost for the more expensive oral drugs and various diagnostic examinations than that of primary health care institution.