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This study was carried out to suggest hospital referral system improvements based on health insurance subscriber perceptions of the delivery of healthcare. Health insurance subscriber outpatients (n = 207) referred from a stage 1 medical institution to the S university hospital located in Seoul responded to the study survey. The study's item reliability is reliable as the Cronbach's alpha coefficient was greater than 0.7. This study results showed that 5.9% of patients were referred from a higher stage hospital to a same stage hospital. The main factor attracting patients to S university hospital were physician reputation and confidence. The highest factor (4.40 ± .92) was xxxx. In addition, survey respondents reported that the concentration of patients in extra-large hospitals in Seoul (4.24 ± .97) was an important issue, and the issue with the highest priority for improvement (4.05 ± 1.02). A positive correlation was detected between the recognition and improvement of delivery of healthcare (p < 0.01). Based on the results, we suggest that improvements in the delivery of healthcare should focus on patients rather than suppliers of national health insurance or other insurers.

Improving Hospital Referral System based on Perception of Delivery of Healthcare by Enrollees