The problems of medical treatment in the Korean correctional facilities are mostly caused by an increase in the number of inmates and inmate patients, shortage of medical staffs and poor medical facilities. These issues have existed throughout the history of correctional facilities. Thus, this study investigates current medical treatment in Korean correctional facilities to improve it and its environment for inmates.
For this purpose, researchers visited over 26 correctional facilities across Korea for 5 months from June to October, 2017, and surveyed of 2,089 inmates to examine actual condition of medical treatment in Korean correctional facilities. Also, in-depth interviews of 88 inmates and medical staffs mainly physicians were conducted for the overall understanding of correctional facilities and considering various aspects to improve the medical treatment environment and its system. Furthermore, online survey of 2,007 people in general was asked to figure out public awareness and examine for comparison with the perception of inmates. Lastly, a comparative study on the medical treatment at the correctional facilities overseas conducted as well by collecting related data through online and offline, and requiring information about corrections to justice departments or correctional facilities in foreign countries.
Based on the results, this study proposes the followings to overcome the current limitations of medical treatment in Korean correctional facilities and increase opportunities for the inmates to get such medical treatment:

1. Expansion of Specialized Correctional Institutions for Medical Treatment

The best way to improve medical treatment in correctional facilities is to build a general hospital-scale medical institute for the inmates from correctional facilities across the country. For this, however, a lot of budget and personnel are required to establish and operate such hospital. Therefore, long-term discussion and preparation are required to establish it.
Regarding the alternative of the establishment of specialized hospital, it could be an option to open a correctional ward in public or private medical institutes. 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 are able to get professional medical services while correctional facilities can save their workforce, which could’ve been applied to medical care. Also, public medical institute can make profits regularly and reduce debt with the patients from the Ministry of Justice.
In addition, correctional facilities and regional correctional departments need to promote exchanges with regional doctors associations, advertise the publicity of medical care in correctional facilities and expand partnered medical institutes by signing an MOU with public medical institutes under the Ministry of Justice. As well, to promote invited medical exam and telemedicine as an alternative medical care in correctional facilities is required if there is a plan to prevent any side effects of telemedicine such as drug overdose before its implementation.

2. Improvement of Hospitalization Environments

In reality, to resolve prison overcrowding is most important to keep patients free from accidents, mental health and infection. Therefore, the size of a living space which at least ensures the minimum quality of life for inmates ought to be stipulated firstly. Then, the quota of current correctional facilities should be reset and adjusted through increasing parole, suspension of punishment, investigation without detention.
In the medical treatment aspects, it is essential to provide sufficient water for cooling/heating and bathing to protect the inmates’ human rights and keep them safe from infectious diseases in summer. Furthermore, treatment/examination rooms in a lady’s ward and solitude room for the isolated treatment of infectious diseases such as T.B. are required. Especially, 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 get the medical exam in the correctional institutions.

3. Building Public Health Care System for the Correctional Facilities

It is necessary to have a medical administration 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 get advisory and assessment services on the medical treatment policies of correctional facilities.
Furthermore, it should be established a cancer and major disease management system and an emergency medical service system in the correctional facilities in close cooperation with related agencies and regional medical institutions. For this, an effective plan could be developed through a legislative method which takes a written consent when an inmate is imprisoned, and a computer system which is connected to the BORAMI system and National health Insurance Service system.

4. Securing of Medical Staffs

For securing of medical staffs in correctional facilities, their salary structure that they have been received much lower pay than private hospitals should be reviewed to ensure reasonable compensation. Considering the unique and particular aspects of public health care for inmate patients, furthermore, the salary of medical staffs in correctional facilities should be increased to a reasonable level, including nighttime/holiday pay and special medical examination benefits.
Also, it is necessary to offer scholarship to the students from medical schools and establish an internal scholarship program in the correctional facilities for recruiting qualified medical staff. Another thing is to promote exchanges with regional medical staff such as regional doctors association and put on ads to secure medical staff working for correctional facilities. As well, paramedical staffs such as nurses, radiologic technologists and emergency medical technicians should be secured.

5. 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 medical treatment in correctional facilities. The Ministry of Justice needs to introduce Practitioners Malpractice and General Liability Insurance in discussion with the Doctors Benefit Association or private insurance company to mitigate medical staff’s burden of malpractice. It is also desirable to offer more opportunities to get medical technology and information through regular maintenance training, workshop, and field trip to advanced correctional facilities.

6. Rationalization of Medical Treatment for Inmate Patients

In terms of inmates’ external medical examination costs, the payment rule about applying expense of the government and one’s own should be clarified with the standards according to the National Health Insurance rates and medical benefit recipient criteria. Also, the types of the drugs provided by correctional facilities are needed to be increased and the regulations on first-aid medicine such as pain relief pills should be mitigated for 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 of Medical Treatment in Correctional Facilities

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