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http://dx.doi.org/10.4332/KJHPA.2021.31.4.491

A Study on Regional Differences in Healthcare in Korea: Using Position Value for Relative Comparison Index  

Youn, Hin-Moi (Department of Public Health, Yonsei University Graduate School)
Yun, Choa (Department of Biostatistics & Computing, Yonsei University Graduate School)
Kang, Soo Hyun (Department of Public Health, Yonsei University Graduate School)
Kwon, Junhyun (Department of Public Health, Yonsei University Graduate School)
Lee, Hyeon Ji (Department of Public Health, Yonsei University Graduate School)
Park, Eun-Cheol (Institute of Health Services Research, Yonsei University)
Jang, Sung-In (Institute of Health Services Research, Yonsei University)
Publication Information
Health Policy and Management / v.31, no.4, 2021 , pp. 491-507 More about this Journal
Abstract
Background: This study aims to measure regional healthcare differences in Korea, and define relatively underserved areas. Methods: We employed position value for relative comparison index (PARC) to measure the healthcare status of 250 areas using 137 indicators in five following domains: healthcare demand, supply, accessibility, service utilization, and outcome. We performed a sensitivity analysis using t-SNE (t-distributed stochastic neighboring embedding). Results: Based on PARC values, 83 areas were defined as relatively underserved areas, 49 of which were categorized as moderate and 34 as severe. The provincial regions with the most underserved areas were Gyeongbuk (16 areas), Gangwon (13), Jeonnam (13), and Gyeongnam (12). Conclusion: This study suggests a relative comparison approach to define relatively underserved areas in healthcare. Further studies incorporating various perspectives and methods are required for policy implications.
Keywords
Relatively underserved areas; Healthcare differences; Regional differences; Regional disparities; Position value for relative comparison index; t-distributed stochastic neighboring embedding;
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1 National Medical Center, Center for Public Healthcare Policy. Health map. Seoul: National Medical Center, Center for Public Healthcare Policy; c2021.
2 Jang SI, Nam JM, Choi J, Park EC. Disease management index of potential years of life lost as a tool for setting priorities in national disease control using OECD health data. Health Policy 2014;115(1):92-99. DOI: https://doi.org/10.1016/j.healthpol.2013.11.007.   DOI
3 Lee HJ, Oh SS, Park EC. Position value for relative comparison of healthcare status of Korea in 2017. Health Policy Manag 2020;30(1):131-138. DOI: https://doi.org/10.4332/KJHPA.2020.30.1.131.   DOI
4 Yoon TH. Regional health inequalities in Korea: the status and policy tasks. J Crit Soc Welf 2010;(30):49-77.
5 Public Health and Medical Services Act, Act No. 13982, Article No. 12 (Feb 3, 2016).
6 National Medical Center; Ministry of Health and Welfare. 2019 Monitoring study on underserved area [Internet]. Seoul: National Medical Center; 2019 [cited 2021 Feb 4]. Available from: https://www.ppm.or.kr/board/thumbnailList.do?MENUID=A04030000.
7 Kim M, Ki M, Kim M, Kim Y, Yoon T, Jang S. Developing health inequalities report and monitoring the status of health inequalities in Korea. Sejong: Korea Institute for Health and Social Affairs; 2014.
8 Sturm R. The effects of obesity, smoking, and drinking on medical problems and costs. Health Aff (Millwood) 2002;21(2):245-253. DOI: https://doi.org/10.1377/hlthaff.21.2.245.   DOI
9 Chae W, Lee SA, Park EC. Position value for relative comparison of healthcare status of Korea among Organization for Economic Cooperation and Development countries, 2015. Health Policy Manag 2018;28(1):98-103. DOI: https://doi.org/10.4332/KJHPA.2018.28.1.98.   DOI
10 Lee SA, Park EC. Position value for relative comparison of healthcare status of Korea in 2014. Health Policy Manag 2017;27(1):88-94. DOI: https://doi.org/10.4332/KJHPA.2017.27.1.88.   DOI
11 Organization for Economic Cooperation and Development. OECD health data [Internet]. Paris: Organization for Economic Cooperation and Development; c2021 [cited 2021 Feb 4]. Available from: https://stats.oecd.org/.
12 Choi J, Kim D, Lee J. Relative regional deprivation in Korea: current state and trends. Health Welf Policy Forum 2019;(272):54-69.
13 Van der Maaten L, Hinton G. Visualizing data using t-SNE. J Mach Learn Res 2008;9(11):2579-2605.
14 Kang H. Healthcare disparities and their policy implications. Health Welf Policy Forum 2019;(270):18-30.
15 Jeon BY, Choi SM, Kim CY. Socioeconomic equity in regional distribution of health care resources in Korea. Health Policy Manag 2012;22(1):85-108. DOI: https://doi.org/10.4332/KJHPA.2012.22.1.085.   DOI
16 Korea Medical Association, Research Institute for Healthcare Policy. Analysis of healthcare underserved area and supporting system. Seoul: Korea Medical Association, Research Institute for Healthcare Policy; 2020.
17 Joo H, Kim J, Kwak J, Lee J, Jung J, Kim HS. Improvement of regional clustering using flood control characteristics and t-SNE of machine learning. J Korean Soc Hazard Mitig 2020;20(3):247-257. DOI: https://doi.org/10.9798/KOSHAM.2020.20.3.247.   DOI
18 Kullback S, Leibler RA. On information and sufficiency. Ann Math Stat 1951;22(1):79-86.   DOI
19 Rank MR, Hirschl TA. The link between population density and welfare participation. Demography 1993;30(4):607-622. DOI:https://doi.org/10.2307/2061809.   DOI
20 Shin HS. Equity in health: regional difference of health service utilization. Health Welf Policy Forum 2011;(176):22-31.
21 Korea Health Promotion Institute. A report on regional healthcare underserved area. Seoul: Korea Health Promotion Institute; 2016.
22 Chang I. Essays on the relationship between population aging and the financial resources of local autonomous entities and medical resources in Korea [dissertation]. Seoul: Seoul National University; 2019.
23 Ministry of Health and Welfare. Underserved area supporting program 2020. Sejong: Ministry of Health and Welfare; 2020.
24 Kwak MY, Lee TH, Hong HS, Na BJ, Kim Y. Development and adjustment of indicators for underserved area. Health Policy Manag 2016;26(4):315-324. DOI: https://doi.org/10.4332/KJHPA.2016.26.4.315.   DOI
25 Lee YJ. A study on the inequality of health care resources distribution affected by regional characteristics. J Crit Soc Welf 2005;(21):48-78.