DOI QR코드

DOI QR Code

Imbalance in Cardiovascular Surgery Medical Service Use Between Regions

  • Kim, Myunghwa (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service) ;
  • Yoon, Seok-Jun (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service) ;
  • Choi, Ji Suk (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service) ;
  • Kim, Myo Jeong (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service) ;
  • Sim, Sung Bo (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine) ;
  • Lee, Kun Sei (Department of Preventive Medicine, Konkuk University School of Medicine) ;
  • Chee, Hyun Keun (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Park, Nam Hee (Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine) ;
  • Park, Choon Seon (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service)
  • Received : 2016.10.05
  • Accepted : 2016.10.24
  • Published : 2016.12.05

Abstract

Background: This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions. Methods: This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service. We identified developments over the 5-year time period and analyzed the level of regional imbalance regarding cardiovascular surgery through the relative comparison of relevance indexes between cardiovascular and other types of surgery. Results: The relevance index was high in large cities such as Seoul, Daegu, and Gwangju, but low in regions that were geographically far from the capital area, such as the Gangwon and Jeju areas. Relevance indexes also fell as the years passed. Cardiovascular surgery has a relatively low relevance index compared to key types of surgery of other fields, such as neurosurgery and colorectal surgery. Conclusion: This study identified medical service use imbalance between regions for cardiovascular surgery. Results of this study demonstrate the need for political intervention to enhance the accessibility of necessary special treatment, such as cardiovascular surgery.

Keywords

References

  1. Organization for Economic Cooperation and Development. Cardiovascular disease and diabetes: policies for better health and quality of care. Paris: Organization for Economic Cooperation and Development; 2015.
  2. Kim YN, Park HJ, Kwon U, Kim KS, Kim MN, Kim SK. Preliminary feasibility study on Daegu Heart Center. Daegu: Keimyung University; 2009.
  3. Yoon SJ, Park CS, Kim MH, et al. Study on the management of cardio-cerebrovascular disease and feasibility evaluation of regional cardiac surgery center. Wonju: Health Insurance Review and Assessment Service; 2015.
  4. Nam MH, Kim SS, Park IS, et al. A study in utilization if non-residential areal in operation. J Korean Acad Ind Coop Soc 2010;11:2078-87.
  5. Delamater PL, Shortridge AM, Messina JP. Regional health care planning: a methodology to cluster facilities using community utilization patterns. BMC Health Serv Res 2013;13:333. https://doi.org/10.1186/1472-6963-13-333
  6. Kim JH, Cho BM, Hwang IK, Son MJ, Yoon TH. Trends of health care utilization and relevance index of stroke inpatient among the self-employed insured and their dependents of national health insurance (1998-2005). Korean J Health Policy Adm 2008;18:66-84. https://doi.org/10.4332/KJHPA.2008.18.4.066
  7. Moon YO, Park EC, Shin HR, et al. Regional variation in accessing regional hospitals for cancer patients. Korean J Epidemiol 2006;28:152-61.
  8. Nemet GF, Bailey AJ. Distance and health care utilization among the rural elderly. Soc Sci Med 2000;50:1197-208. https://doi.org/10.1016/S0277-9536(99)00365-2
  9. Joseph AE, Boeckh JL. Locational variation in mental health care utilization dependent upon diagnosis: a Canadian example. Soc Sci Med D 1981;15:395-40.
  10. Kim DJ, Park KH, Isamukhamedov SS, Lim C, Shin YC, Kim JS. Clinical results of cardiovascular surgery in the patients older than 75 years. Korean J Thorac Cardiovasc Surg 2014;47:451-7. https://doi.org/10.5090/kjtcs.2014.47.5.451