Status and Future Tasks of the Regional Infectious Disease Specialized Hospital Establishment Project for Responding to Large-scale Emerging Infectious Disease Crises

Abstract

Objectives

This study presents the policy background, implementation status, and future directions of the Regional Infectious Disease Specialized Hospital Establishment Project. This initiative was launched to overcome the structural weaknesses in the national medical response system exposed during the 2015 Middle East respiratory syndrome outbreak and to significantly enhanced preparedness for future emerging infectious disease threats.

Methods

The project was institutionalized through the 2015 revision of the “Infectious Disease Control and Prevention Act” and was subsequently followed by the designation of regional infectious disease specialized hospitals through a systematic competitive selection process. Following designation, the project has been implemented through phased reviews and adjustments in accordance with the Total Project Cost Management System mandated by the National Finance Act.

Results

Beginning in 2017, regional infectious disease specialized hospitals have been established across five regions (Honam, Chungcheong, Gyeongnam, Gyeongbuk, and the Capital region). The Honam region has progressed to the construction phase, while the Chungcheong, Gyeongnam, and Gyeongbuk regions are in the design stage, and the Capital region is preparing for total project cost adjustment following the completion of the feasibility re-evaluation. Each hospital is built as an independent facility equipped with essential infrastructure such as negative-pressure wards (36 beds or more), negative-pressure operating rooms, high-containment laboratories, and education and training facilities. They function as regional hubs providing diagnosis, treatment, and training during non-crisis periods and offering critical patient isolation, treatment, and coordinated regional responses during public health emergencies.

Conclusions

Regional infectious disease specialized hospitals serve as pivotal hubs for coordinating infectious disease preparedness and response during both non-crisis and crises. The Korea Disease Control and Prevention Agency aims to reinforce the national medical safety net by advancing hospital construction while also establishing regional systems for workforce training, patient referral and transfer, and inter-institutional cooperation networks, even before hospital completion.

Key messages

① What is known previously?

The 2015 Middle East respiratory syndrome outbreak revealed structural weaknesses in the national medical response system, leading to the establishment of an institutional framework for the regional infectious disease specialized hospitals through amendments to the “Infectious Disease Control and Prevention Act”.

② What new information is presented?

From 2017 onwards, five regional infectious disease specialized hospitals have been designated and the project has been under active implementation. Each hospital is being constructed as an independent facility equipped with negative-pressure wards, negative-pressure operating rooms, and education and training facilities. These facilities provide diagnostic, treatment, and training functions during non-crisis periods, while serving as critical hubs for patient isolation, treatment, and coordinated regional response during public health emergencies.

③ What are implications?

Regional infectious disease specialized hospitals function as core coordination centers to enhance the robustness of the Republic of Korea’s medical response capacity and reinforce the national preparedness framework for future infectious disease crises.

Introduction

The emergence of infectious diseases poses a significant threat to public health due to their rapid transmission over short periods, often resulting in large-scale outbreaks and high fatality rates, thereby imposing a substantial burden on society and the economy. During the 2015 Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea, a single imported case resulted in 186 confirmed infections within two months, with a fatality rate of approximately 20%, demonstrating the severity of hospital-based transmission [1]. At the time, state-designated inpatient treatment beds were limited to three to nine rooms per hospital, making them inadequate for responding to large-scale patient surges. Although regional hub hospitals existed, they proved insufficient in their capacity to simultaneously isolate and treat large numbers of patients [2]. Moreover, delays in patient transfer processes and insufficient critical care infrastructure in the region underscored systemic limitations in the national medical response system [2,3].

This experience demonstrated that short-term, temporary measures alone are insufficient. The need for a specialized infectious disease infrastructure—operating on a permanent basis during non-crisis periods and equipped with a qualitatively improved medical treatment and isolation system—has become a key policy priority. Establishing dedicated infrastructure capable of performing high-level functions, such as the rapid isolation and treatment of critically ill patients within the region, transfer coordination, and negative-pressure surgery, has been emphasized, particularly given the risks of deteriorating patient conditions and secondary transmission associated with long-distance transport. The Singapore National Centre for Infectious Diseases, established as a specialized hospital for infectious diseases, integrates clinical care, isolation, research, and public health functions on an ongoing basis [4], enabling it to maintain large-scale patient capacity, operate a rapid regional response system, and sustain a dedicated infectious disease workforce at all times.

Following the 2015 MERS outbreak, the government released the “Measures to Reform the National Infection Prevention and Control System” and amended the “Infectious Disease Control and Prevention Act” within the same year. These actions formed the institutional foundation for the establishment of regional infectious disease specialized hospitals [5]. The project was launched in earnest in 2017. The need to strengthen the capacity of infectious disease specialized hospitals became even more apparent during the coronavirus disease 2019 (COVID-19) pandemic in 2020, accelerating the project’s progress. The initiative aims to mitigate the spread of large-scale outbreaks across regions, ensure the rapid isolation and treatment of patients, and improve accessibility for local residents to support early detection and response. Furthermore, it seeks to establish a foundation for more effective responses to emerging infectious disease crises by serving as a central coordinating body that manages and oversees a wide range of activities, from routine regional infectious disease control to the development and operation of crisis response systems. This policy report provides an overview of the policy background and institutional framework of regional infectious disease specialized hospitals. It also outlines the progress made from their initial designation in 2017 to November 2025 and presents future directions for the project’s implementation.

Methods

1. Legal Basis

Following the 2015 MERS outbreak, the government introduced the “Measures to Reform the National Infection Prevention and Control System” within the same year, thereby initiating the establishment of an institutional framework for regional infectious specialized disease hospitals. In December 2015, the “Infectious Disease Control and Prevention Act” (Act No. 13639, December 29, 2015) was amended, followed by amendments to the Enforcement Decree of the same Act (Presidential Decree No. 27277, June 28, 2016) in June 2016. Through this process, Article 8-2 (Infectious Disease Hospitals) of the Act and Article 1-4 (Designation of Regional Infectious Disease Specialized Hospitals) of the Enforcement Decree were newly established, providing the legal basis for the designation and operation of regional hospitals specializing in infectious diseases [5,6]. In particular, the establishment of a designated institutional framework—under which the Commissioner of the Korea Disease Control and Prevention Agency (KDCA) formally designates and announces pertinent matters—serves as a cornerstone for the consistent and stable operation of a national-level management system.

2. Designation Procedure for Regional Infectious Disease Specialized Hospitals

The designation of regional infectious disease specialized hospitals is conducted through a structured competitive selection process. Once the Regional Selection Committee identifies eligible regions—taking into account factors such as population distribution, medical infrastructure, and transportation accessibility—a public bidding process is initiated for those designated regions. Participation is limited to general hospitals or tertiary general hospitals as defined under the Medical Service Act. Institutions submitting proposals are evaluated by the Selection Evaluation Committee based on their project plans. The evaluation proceeds in a sequential manner, beginning with a written assessment, followed by a presentation assessment, and concluding with an on-site assessment. Key evaluation criteria include the current status of infectious disease response infrastructure, plans for establishing and operating an infectious disease specialized hospital, and the suitability of the proposed site. After this comprehensive review, the final institution is selected, and the Commissioner of the KDCA formally designates and publicly announces the regional infectious disease specialized hospital.

3. Total Project Cost Management System

The Total Project Cost Management System is a framework designed to ensure the efficient use of fiscal resources and the stable implementation of projects through systematic, phased management and adjustment of large-scale national treasury–funded projects (preliminary feasibility study→basic plan→basic design [schematic design and design development]→design development→commencement→completion). Construction projects with total costs exceeding KRW 20 billion fall under this management system, and the regional infectious disease specialized hospital construction project is included in this category. Accordingly, the project must undergo adjustments at each implementation stage, in consultation with the Ministry of Economy and Finance, regarding project scale, costs, and duration. During the design phase, projects are subject to a design adequacy review by the Public Procurement Service. If deemed necessary, the Ministry of Economy and Finance may also conduct a feasibility assessment or re-examine the adequacy of the project plan. Even after groundbreaking, if unavoidable factors arise, such as price fluctuations or design changes, the total project cost adjustment procedure is applied. Final decisions regarding total project cost adjustments are made either through autonomous adjustment by the central government agency or through deliberation by the Ministry of Economy and Finance. The Regional Infectious Disease Specialized Hospital Construction Project is a large-scale national treasury-subsidized project. It is strictly managed at every stage under the framework of the National Finance Act, ensuring institutional guarantees for fiscal transparency and public interest (Figure 1).

Figure 1. Implementation procedures for the regional infectious disease specialized hospitals project.

PPS=Public Procurement Service; MOEF=Ministry of Economy and Finance.

Results

1. Content

The Regional Infectious Disease Specialized Hospital Construction Project is subject to total project cost management under the “National Finance Act” and is being implemented through a structure in which the central government and healthcare institutions share the financial burden. The construction of these hospitals is planned in a manner that ensures their physical separation from existing general wards, thereby reducing the risk of cross-infection during the treatment of patients with infectious diseases. Key facilities include negative-pressure isolation rooms (36 beds or more) that enable the safe isolation and treatment of patients during large-scale outbreaks, as well as negative-pressure operating rooms that support emergency surgeries and high-risk procedures. Additionally, a clinical laboratory will be established to facilitate rapid and accurate diagnosis of novel infectious pathogens. Training facilities will also be provided to strengthen the competencies of infectious disease response specialists during non-crisis periods. These facilities serve as essential infrastructure for sustaining preparedness, extending beyond mere bed expansion to prevent secondary infections within healthcare settings and to ensure hospitals are equipped to manage large-scale outbreaks of emerging infectious diseases.

2. Key Roles

Regional infectious disease specialized hospitals serve as essential infrastructure, overseeing infectious disease response within their respective regions. They perform the following roles during both non-crisis periods and crisis situations. During non-crisis periods, these hospitals are responsible for the continuous diagnosis and treatment of patients with infectious diseases. They strengthen response capabilities by providing education, conducting simulation exercises, and operating infection control programs for infectious disease response specialists. They also establish and maintain cooperative networks with regional healthcare organizations and conduct infectious disease surveillance and prevention activities. During crises, negative-pressure beds and negative-pressure operating rooms, including intensive care units, are utilized to rapidly isolate and treat patients in response to emerging infectious disease outbreaks. In addition, based on a collaborative framework established with regional medical institutions, these hospitals coordinate patient admissions based on severity and manage patient referrals and transfers. The hospitals also provide rapid diagnostic support through high-risk pathogen laboratories and conduct epidemiological investigations and other disease control activities.

3. Designation Status

A comprehensive evaluation of population size, distribution of medical resources, and geographic accessibility resulted in the designation of five regional infectious disease specialized hospitals across five regions as of November 2025, following a competitive selection process (Figure 2). Beginning with Chosun University Hospital in the Honam region in 2017, additional designations were made in 2020 for Soonchunhyang University Cheonan Hospital in the Chungcheong region and Pusan National University Yangsan Hospital in the Gyeongnam region. Subsequently, Kyungpook National University Chilgok Hospital was designated in the Gyeongbuk region in 2021, and Seoul National University Bundang Hospital was designated in the Capital region in 2022.

Figure 2. Designation status of central and regional infectious disease specialized hospitals.

^a)Central Infectious Disease Specialized Hospital: national-level coordination of infectious disease response and inter-regional coordination. ^b)Regional Infectious Disease Specialized Hospital: regional infectious disease response and cooperation functions, including coordination of patient transfers.

4. Project Implementation Status by Region

The five regional infectious disease specialized hospitals are being implemented in accordance with the total project cost management guidelines after being designated, and as of November 2025: the Honam region is in the construction phase; the Chungcheong, Gyeongnam, and Gyeongbuk regions are in the design phase; the Capital region has passed the feasibility re-evaluation and is preparing for total project cost adjustment (Table 1).

Table 1. Status of the regional infectious disease specialized hospitals project (as of November 2025).

	Honam region	Chungcheong region	Gyeongnam region	Gyeongbuk region	Capital region
Hospital	Chosun University Hospital	Soonchunhyang University Cheonan Hospital	Pusan National University Yangsan Hospital	Kyungpook National University Chilgok Hospital	Seoul National University Bundang Hospital
Designation date	August 21, 2017	July 31, 2020	July 31, 2020	July 26, 2021	April 13, 2022
Project phase	Construction phase	PPSRedesign of design development appropriateness review	Total project cost adjustment (following KDIproject plan adequacy re-review)	Total project cost adjustment (following PPSdesign development adequacy review)	Preparation for the total project cost adjustment (following KDIfeasibility re-evaluation)

PPS=Public Procurement Service; KDI=Korea Development Institute.

1) Honam region

Chosun University Hospital was the first institution designated as a regional infectious disease specialized hospital in August 2017. In September 2023, the total project cost was confirmed at approximately KRW 78.1 billion (KRW 58.2 billion in national funding and KRW 19.9 billion in self-financing). An independent infectious disease ward with a total floor area of 13,202 m²—comprising seven above-ground floors and two basement floors, and accommodating 98 beds—is currently under construction on a site in Dong-gu, Gwangju Metropolitan City. Construction officially began in June 2024 and remains underway as of November 2025. Despite challenges related to project delays, partly attributable to the step-by-step procedures required to finalize the total project cost and rising construction prices, the need to expand infectious disease specialized hospital capacity became increasingly evident during the COVID-19 pandemic, helping accelerate project progress. As the nation’s first healthcare institution specifically designed to play a central role in infectious disease response, the facility aims to begin operations in 2027 [7,8].

2) Chungcheong region

Soonchunhyang University Cheonan Hospital was designated as the infectious disease specialized hospital for the Chungcheong region in July 2020. As of November 2025, it has completed the redesign of design development and is undergoing a design adequacy review by the Public Procurement Service. During the implementation process, the design development was modified due to various internal and external factors. The revised design, which incorporates operational efficiency and other considerations, is currently under an additional appropriateness review by the Public Procurement Service. Based on the results of this review, discussions with the Ministry of Economy and Finance regarding adjustments to the total project cost are expected to continue.

3) Gyeongnam region

Pusan National University Yangsan Hospital was designated as the infectious disease specialized hospital for the Gyeongnam region in July 2020. Following the completion of the design development adequacy review by the Public Procurement Service and a subsequent re-evaluation of the project plan’s adequacy by the Korea Development Institute, the hospital is currently engaged in negotiations with the Ministry of Economy and Finance regarding adjustments to the total project cost as of November 2025. During implementation, the total project cost for the Gyeongnam region project increased beyond the threshold requiring a preliminary feasibility study (KRW 50 billion), making the project to a re-evaluation of feasibility in accordance with Article 49, Paragraph 1, Item 1 of the Total Project Cost Management Guidelines. However, as an exemption from the preliminary feasibility study had already been approved in 2016, a re-examination of the project plan’s appropriateness was conducted instead. The construction documents phase will proceed based on the outcomes of future discussions on the total project cost adjustment.

4) Gyeongbuk region

Kyungpook National University Chilgok Hospital was designated as the infectious disease specialized hospital for the Gyeongbuk region in July 2021. After completing the design development adequacy review by the Public Procurement Service, it is currently in discussions with the Ministry of Economy and Finance regarding adjustments to the total project cost as of November 2025. The Gyeongbuk region project is also under review as a candidate for re-evaluation due to its total project cost exceeding the threshold that triggers the requirement for a preliminary feasibility study (over KRW 50 billion), as stipulated in Article 49, Paragraph 1, Item 1 of the Total Project Cost Management Guidelines. Moving forward, proactive efforts will be made to identify and incorporate various potential benefit factors to respond effectively during the feasibility re-evaluation.

5) Capital region

Seoul National University Bundang Hospital was designated as the infectious disease specialized hospital for the Capital region in April 2022. After establishing its basic plan in the same year, the region passed the feasibility re-evaluation on November 27, 2025, and is preparing for total project cost adjustment. Unlike other regions, the Capital region plans to adopt a turnkey bidding system for both design and construction. Once the Ministry of Economy and Finance completes its review of the total project cost—based on the results of the feasibility re-evaluation—the project will proceed to the Ministry of Land, Infrastructure and Transport for deliberation on the large-scale project execution plan. This will be followed sequentially by construction project management, design, and contractor selection procedures.

Conclusion

The Regional Infectious Disease Specialized Hospital Construction Project has been implemented as a core national initiative to address structural limitations in the national medical response system and to strengthen proactive preparedness for emerging infectious disease crises. Beginning with the Honam region in 2017, infectious disease specialized hospitals have now been designated across five regions. As of November 2025, the Honam region is in the construction phase, while the Chungcheong, Gyeongnam, and Gyeongbuk regions remain in the design phase. The Capital region has completed its basic plan, has passed the feasibility re-evaluation, and is preparing for total project cost adjustment. Projects are being advanced in a phased manner based on the conditions of each region.

However, the procedures required under the total project cost management framework have necessitated considerable time, and project schedules have been delayed due to various internal and external factors, including rising prices, issues within the domestic medical community, and deteriorating hospital management environments. Nevertheless, the KDCA has taken proactive steps to address and resolve challenges by conducting monthly project reviews and operating a consultative body in collaboration with relevant agencies. Furthermore, through close cooperation with organizations such as the Public Procurement Service and the Ministry of Economy and Finance, the KDCA ensures stable project execution by rigorously carrying out each procedural stage required under the Total Project Cost Management Guidelines. The KDCA will continue to strengthen this cooperative system to minimize implementation challenges and proactively mitigate delays.

Meanwhile, even before the hospitals become fully operational, efforts are underway to establish a regionally comprehensive medical response system that supports the statutory functions of infectious disease specialized hospitals. This initiative seeks to build a collaborative framework centered on regional infectious disease specialized hospitals, linking central, regional, and local systems through local governments, regional disease response centers, and local medical institutions. This will enable infectious disease specialized hospitals to effectively fulfill their core responsibilities. Key components include developing personnel training programs tailored to regional needs, establishing patient referral and transfer procedures, and creating permanent collaborative networks among local governments and medical institutions. These efforts are constructing a regional cooperative system that has been lacking to date, addressing the limitations of centralized response models, building a foundation for routine-time collaboration, and ensuring the capacity for coordinated responses during crises [9].

In the future, the KDCA will continue to work in close cooperation with relevant ministries and regional hospitals to expedite the development of infectious disease specialty hospitals while advancing the regional comprehensive medical response system project. These efforts will strengthen the foundation for efficient infectious disease response and enhance national-level crisis response capabilities in a systematic manner. Ultimately, the KDCA aims to establish a robust medical safety net to proactively prepare for and respond to future infectious disease crises.