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Background: This study was to provide an analysis of long-term care hospitals in major foreign countries and to ultimately drive suggestions for the role of the long-term care hospital system in Korea. Methods: Services, composition of the workforce, admission criteria, and collaboration with related organization were reviewed. Japan, Canada, United States (US) and the Netherlands were selected for analysis using the case study research method. Results: Organization for Economic Co-operation and Development (OECD) defined long-term care hospital as long-term care beds in hospitals. A few OECD countries institutionalized long-term care beds in hospitals, focusing at palliative care or geriatric care. In Japan, Canada, US, and the Netherlands, all having similar long-term care hospitals as Korea, a key difference was that the hospitals in these four countries provide comprehensive post-acute and nursing care. They have clearly defined admission criteria by preadmission review and systemization of referral from other organizations. Conclusion: Based on this review of the systems in foreign countries serving as examples for Korea and considering the policy needs and the present problems raised by providers, discussions on the future role of long-term care hospitals in Korea should be conducted.