[History and Trends in Hospitalization Orders for Tuberculosis Patients in the Republic of Korea (2011-2024)].

Objectives: Tuberculosis (TB) is a common infectious respiratory disease requiring long-term treatment, which increases the risk of treatment discontinuation. State institutional intervention is thus inevitable. We reviewed the background, history and current implementation status of hospitalization orders for patients with TB in the Republic of Korea. Methods: We analyzed historical legislation and regulations within The Tuberculosis Prevention Act, national TB control plans, and management guidelines. Additionally, we reviewed data on hospitalization orders from the Korea Tuberculosis Surveillance System (KTB-Surv) and collected by the Korea Tuberculosis Network (KTB-Net). Results: Hospitalization orders were issued for approximately 1% (0.7-1.4%) of annual TB cases from 2011 to 2023. Multidrug-resistant-TB was the dominant diagnosis associated with such orders in the early years (2012-2015) of the program. After 2016, following the full waiver of out-of-pocket medical expenses for TB treatment, the proportion of cases classified as "other diagnoses" (including severely vulnerable and elderly patients) increased significantly from 1.6% to 36.8%. Conclusions: The hospitalization order system plays a critical role in improving treatment compliance and prevent TB transmission within communities. It also provides active support for medical and living expenses during inpatient isolation. Strategic reforms are needed to ensure the system adapts to future challenges, including those precipitated by population aging and changing family structures.