This paper presents an analysis of the current status of domestic hospital industry which went trough the time of new hospitals operated by chaebols from 1994 to 2003 and the dramatic changes of medical service environment such as IMF relief loan in 1997 and the separation of prescription and dispensing (SPD) in 2000. For the sake of righteous policy-making in the future, this paper presents a productivity analysis of the management and administration of 38 tertiary hospitals nationwide in the past 10 years. The analysis is based on the Malmquist index approach using linear programming. d prepare a productivity index that measures not merely efficiency but the technological evolution and adjustment to changing environments.