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http://dx.doi.org/10.3346/jkms.2016.31.11.1684

The Ecology of Medical Care in Korea  

Kim, Yong-Soo (Public Health Policy Institute, Seoul Metropolitan Government)
Choi, Yong-jun (Department of Social and Preventive Medicine, College of Medicine, Hallym University)
Publication Information
Journal of Korean Medical Science / v.31, no.11, 2016 , pp. 1684-1688 More about this Journal
Abstract
This study aimed to describe the ecology of medical care in Korea. Using the yearly data of 2012 derived from the Korea Health Panel, we estimated the numbers of people per 1,000 residents aged 18 and over who had any health problem and/or any medical care at a variety of care settings, such as clinics, hospitals, and tertiary hospitals, in an average month. There was a total of 11,518 persons in the study population. While the number of those who had any health problem in an average month was estimated to be 939 per 1,000 persons, the estimated numbers of ambulatory care users were 333 at clinics, 101 at hospital outpatient departments, 35 at tertiary hospital outpatient departments, and 38 for Korean Oriental medical providers. The number of people who used emergency care at least once was 7 per 1,000 persons in an average month. The numbers of people hospitalized in clinics and hospitals were 3 and 8, respectively, while 3 persons were admitted to tertiary hospitals. There was a gap between the number of people experiencing any health problem and that of those having any medical care, and primary care comprised a large share of people's medical care experiences. It was noteworthy that more patients received ambulatory care at tertiary hospitals in Korea than in other countries. We hope that discussion about care delivery system reform and further studies will be encouraged.
Keywords
Delivery of Health Care; Primary Health Care; Health Services Rresearch; Republic of Korea;
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Times Cited By KSCI : 4  (Citation Analysis)
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1 Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan 2009; 24: 63-71.
2 Choi YJ, Ko BS, Cho KH, Lee JH. Concept, values, current status and prospect of primary care in Korea. J Korean Med Assoc 2013; 56: 856-65.   DOI
3 Lee JY, Jo MW, Yoo WS, Kim HJ, Eun SJ. Evidence of a broken healthcare delivery system in Korea: unnecessary hospital outpatient utilization among patients with a single chronic disease without complications. J Korean Med Sci 2014; 29: 1590-6.   DOI
4 Organisation for Economic Co-operation and Development. OECD Reviews of Health Care Systems: Korea. Paris: OECD Publications Service, 2003.
5 Organisation for Economic Co-operation and Development. OECD Reviews of Health Care Quality: Korea - Raising Standards. Paris: OECD Publications Service, 2012.
6 Green LA, Fryer GE Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med 2001; 344: 2021-5.   DOI
7 Thacker SB, Greene SB, Salber EJ. Hospitalizations in a southern rural community: an application of the 'ecology model'. Int J Epidemiol 1977; 6: 55-63.   DOI
8 Dovey S, Weitzman M, Fryer G, Green L, Yawn B, Lanier D, Phillips R. The ecology of medical care for children in the United States. Pediatrics 2003; 111: 1024-9.   DOI
9 Fryer GE Jr, Green LA, Dovey SM, Yawn BP, Phillips RL, Lanier D. Variation in the ecology of medical care. Ann Fam Med 2003; 1: 81-9.   DOI
10 Bliss EB, Meyers DS, Phillips RL Jr, Fryer GE Jr, Dovey SM, Green LA. Variation in participation in health care settings associated with race and ethnicity. J Gen Intern Med 2004; 19: 931-6.   DOI
11 Chou LF. The ecology of mental health care in Taiwan. Adm Policy Ment Health 2006; 33: 492-8.   DOI
12 White KL, Williams TF, Greenberg BG. The ecology of medical care. N Engl J Med 1961; 265: 885-92.   DOI
13 Horder J, Horder E. Illness in general practice. Practitioner 1954; 173: 177-87.
14 Fukui T, Rhaman M, Takahashi O, Saito M, Shimbo T, Endo H, Misao H, Fukuhara S, Hinohara S. The ecology of medical care in Japan. Japan Med Assoc J 2005; 48: 163-7.
15 Leung GM, Wong IO, Chan WS, Choi S, Lo SV; Health Care Financing Study Group. The ecology of health care in Hong Kong. Soc Sci Med 2005; 61: 577-90.   DOI
16 Yawn BP, Fryer GE, Phillips RL, Dovey SM, Lanier D, Green LA. Using the ecology model to describe the impact of asthma on patterns of health care. BMC Pulm Med 2005; 5: 7.   DOI
17 Ferro A, Kristiansson PM. Ecology of medical care in a publicly funded health care system: a registry study in Sweden. Scand J Prim Health Care 2011; 29: 187-92.   DOI
18 Shao CC, Chang CP, Chou LF, Chen TJ, Hwang SJ. The ecology of medical care in Taiwan. J Chin Med Assoc 2011; 74: 408-12.   DOI
19 Ishida Y, Ohde S, Takahashi O, Deshpande GA, Shimbo T, Hinohara S, Fukui T. Factors affecting health care utilization for children in Japan. Pediatrics 2012; 129: e113-9.   DOI
20 Hansen AH, Halvorsen PA, Forde OH. The ecology of medical care in Norway: wide use of general practitioners may not necessarily keep patients out of hospitals. J Public Health Res 2012; 1: 177-83.
21 Roncoletta A, Gusso GD, Bensenor IM, Lotufo PA. A reappraisal in Sao Paulo, Brazil (2008) of "The Ecology of Medical Care:" the "One Per Thousand's Rule". Fam Med 2012; 44: 247-51.
22 Shao S, Zhao F, Wang J, Feng L, Lu X, Du J, Yan Y, Wang C, Fu Y, Wu J, et al. The ecology of medical care in Beijing. PLoS One 2013; 8: e82446.   DOI
23 Chang CP, Chou CL, Chou YC, Shao CC, Su HI, Chen TJ, Chou LF, Yu HC. The ecology of gynecological care for women. Int J Environ Res Public Health 2014; 11: 7669-77.   DOI
24 Tokunaga S, Sameshima H, Ikenoue T. Applying the ecology model to perinatal medicine: from a regional population-based study. J Pregnancy 2011; 2011: 587390.
25 Duwe EA, Petterson S, Gibbons C, Bazemore A. Ecology of health care: the need to address low utilization in American Indians/Alaska Natives. Am Fam Physician 2014; 89: 217-8.
26 Vo TL, Duchesnes C, Vogeli O, Belche JL, Massart V, Giet D. The ecology of health care in a Belgian area. Acta Clin Belg 2015; 70: 280-6.   DOI
27 Johansen ME, Kircher SM, Huerta TR. Reexamining the ecology of medical care. N Engl J Med 2016; 374: 495-6.   DOI
28 Jeong YH, Ko SJ, Son CK, Lee JH, Lee YG, Seo NK, Tae YH, Kim YS. A Report on the Procedure of Korea Health Panel Survey. Seoul: Korea Institute for Health and Social Affairs; National Health Insurance Corporation, 2008.
29 Statistics Korea. Korean Statistical Information Service [Internet]. Available at http://kosis.kr [accessed on 18 March 2016].
30 Cho JJ, Kwon YJ, Jung SH. Community based health care service design on chronic disease for enhancing primary care and the status of community based primary care project. Korean J Fam Pract 2015; 5: 173-8.
31 Kim K, Lee S, Park H. Reforming medical education for strengthening primary care. J Korean Med Assoc 2013; 56: 891-8.   DOI
32 Kim YI, Hong JY, Kim K, Goh E, Sung NJ. Primary care research in South Korea: its importance and enhancing strategies for enhancement. J Korean Med Assoc 2013; 56: 899-907.   DOI
33 Armstrong D. Outline of Sociology as Applied to Medicine. 5th ed. London: Arnold Publication, 2003.
34 Fry J, Moulds A, Strube G, Gambrill E. The Family Good Health Guide: Common Sense on Common Health Problems. Lancaster: MTP Press Limited, 1982.