• Journal of the Economic Geographical Society of Korea
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• v.1 no.2
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• pp.71-84
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• 1998

Health has been seen as a resource necessary for both maintaining oneself and for living in a society pursuing high quality of life. Therefore, the medicare provision takes place of one of the most significant indexes for evaluating the regional welfare level. The purpose of this study is to investigate the locational characteristics of medicare service facilities. For the purpose, the distribution patterns of the medicare resources are analyzed both at the regional and local scales. The medicare resources are concentrated at the Metropolitan Seoul area in the regional scale, and they are also concentrated at the economic core areas in the local scale. Especially, higher level medicare resources, such as the general hospitals and medical specialists, show more concentration at the economic core areas than lower level services. This means that access to opportunities to receive higher level medicare is poorer in a more socially disadvantaged area. Since medicare service facilities are invested and operated by both private and public sectors, whose locational mechanisms are deferent, we analyzed the distribution patterns. Most medicare facilities are invested and managed by private sector in Korea, which is operated by market mechanism. This is related with the fact that the medicare facilities are concentrated at the economic core areas. The proportion of private sector is higher in the Metropolitan Seoul area, and thus this region shows stronger spatial disparity of medicare provision. In general, the medicare service facilities are located in the hierarchical structure, and thus the services levels and facility scales are differentiated by the hierarchy. We examined the hierarchical structure in the medicare service facilities in Korea. The referral medicare system has been applied with the assumption of the three level hierarchical structures in Korea. However, we could not find any distinct hierarchical structure in the scales of the medical service facilities.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.61-69
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• 1979

In Korea, the regional differences of medical facilities and man-powers are very serious recently. in order to solve rural medical problem, the comprehensive health care service is required earnestly in rural area. The present study was performed to provide the material for rural medical policy by analyzing the diseases occurring frequently in rural area and assuming the paramedical workers' abilities of medical treatment. The frequently by occurring diseases were classified by investigating. The chief complaints of 4559 subjects through home visiting for last weeks occurred in 1978. The paramedical workers' abilities of medical treatment were investigated by analyzing the clinical charts of patients treated by paramedical workers by systemic health care delivery system from, September 1977 to December 1977. The results obtained are summarized as fellows; 1. The rate of disease suffering recently for 2 weeks was 22.5% in Rural area. 2. The rate of respiratory disease was 36.%, gastrointestinal disease 18%, trauma 8% and neuromuscular disease 7.5%, respectively. 3. The coverage of treatment by health workers was 97.6% in general practitioner, 70% in community health practitioner and 42.1% in community health aid, respectively.

• Journal of the Korean association of regional geographers
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• v.17 no.5
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• pp.617-637
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• 2011

This study employs qualitative approaches to examining geographical characteristics and patients' determinants of online referrals in terms of regionalization. In this light, I conducted interviews with 20 patients receiving online referrals in Choongbook, Korea, and investigated their behaviors regarding these referrals between July and August 2009. I found that many patients who suffered from various levels of illness preferred tertiary care centers outside of Choongbook and did not enjoy their experience with the local medical institutions as the online referral service sites. This result might be because patients choose online referrals for psychological considerations such as quality and level of health care services, personal stakes in online referral service sites, acceptability and credibility of good tertiary care centers, and easy access to and use of medical institutions. Meanwhile, immediate benefits with regard to the technological value of online referrals, such as convenience, utility, and original purpose associated with regionalization, did not influence patients' decision-making. Therefore, the social and public networks affiliated with online referrals plus the effect of Korean medical laws play hostage to private decisions made by citizens, who prefer high-level medical institutions. Accordingly, the technological contribution of online referrals does not halt the outflow of patients from local, tertiary care centers. Especially, the existing health care system and patients' behaviors are deeply related to referrals in the online system. To protect regionalization, the improvement of health care services from the present state of affairs is required.

• Journal of Preventive Medicine and Public Health
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• v.47 no.6
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• pp.289-297
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• 2014

Objectives: This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea. Methods: The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs). Results: Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture. Conclusions: Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.67-75
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• 2009

Objectives: This study was conducted to examine health inequality for gender and region in Korea. Especially it focused on health status such as disease prevalence and medical utilization of rural women. Methods: Data from the Korea national health and nutrition survey in 2001 were used. The final sample size was 37,108 individuals with age 20 and over. This study applied the logistic regression for nominal variables such as disease prevalence and unmet care needs and with the regression for continuos variables such as the length and costs of medical services. Results: Rates of disease prevalence and unmet care needs for chronic disease in rural area are higher than those in middle cities and big cities, and regional differences of those for women are more than those for mens with controlling ages. There could be interaction effect with region and sex. Conclusions: This study suggests that health policy maker should take consider of special status of rural women who are in health inequality.

• Environmental Analysis Health and Toxicology
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• v.31
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• pp.3.1-3.11
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• 2016

Objectives This study was conducted to describe the regional malaria incidence in relation to the geographic and climatic conditions and describe the effect of altitude on the expansion of malaria over the last decade in Papua New Guinea. Methods Malaria incidence was estimated in five provinces from 1996 to 2008 using national health surveillance data. Time trend of malaria incidence was compared with rainfall and minimum/maximum temperature. In the Eastern Highland Province, time trend of malaria incidence over the study period was stratified by altitude. Spatio-temporal pattern of malaria was analyzed. Results Nationwide, malaria incidence was stationary. Regionally, the incidence increased markedly in the highland region (292.0/100000/yr, p =0.021), and remained stationary in the other regions. Seasonality of the malaria incidence was related with rainfall. Decreasing incidence of malaria was associated with decreasing rainfall in the southern coastal region, whereas it was not evident in the northern coastal region. In the Eastern Highland Province, malaria incidence increased in areas below 1700 m, with the rate of increase being steeper at higher altitudes. Conclusions Increasing trend of malaria incidence was prominent in the highland region of Papua New Guinea, while long-term trend was dependent upon baseline level of rainfall in coastal regions.

• Journal of Preventive Medicine and Public Health
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• v.39 no.3
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• pp.263-269
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• 2006

Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.1-14
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• 2004

Objectives: We investigated the factors related to health examination behaviors, sociodemographic aspects and lifestyles of elderly persons with different social backgrounds, and compared sexual and regional differences in urban and rural elderlies. Methods: The total study subjects(464 individuals) from urban(236) and rural areas(228), recruited by a stratified cluster random sampling were interviewed and examined about their sociodemographic profiles, daily lifestyles, subjective health status, conditions concerning use of medical resources, hearing acuity, visual acuity and ADL(activity of daily living), and whether they receive health examination or not. For statistical analysis, Chi-square test was used for sexual and regional comparisons among the groups who have been given a health examination and the one who have not. Results: In urban areas, the rate of having underwent health examination was 54.5% in men and 46.9% in women, and in rural areas, it was 59.8% in men and 42.7% in women, showing its higher rate in men than in women in both areas. For regional differences between the group who have taken a health examination and the one who have not, there was a significant difference in terms of age, family pattern, current job, monthly household income, owning a house, drinking status, eating habit, subjective health status, whether they have taken outpatient medical service for the recent 3 months or not, anxiety for the health, and IADL conditions according to whether the community is rural or urban. In multiple regressions, the influential factors on the health examination behaviors were selected such as having their own house, their family doctor, amnesia, urinary incontinence and chronic disease in urban districts. But in rural districts, the variables were selected such as having or not of their family doctor, urinary incontinence, anxiety for the health, educational level, their own house and chronic disease. Conclusions: It is suggested that the approach to the health examination of an older patient requires substantial consideration of highly variable individual sociodemographic characteristics involving regional attributes as well as their daily life styles, subjective health status, status of performing health examination, physical health status and ADL conditions.

• Health Policy and Management
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• v.28 no.3
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• pp.195-196
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• 2018

The Korean Academy of Health Policy and Management (KAHPM) has shown remarkable achievements in the field of health policy and management in Korea for the last 30 years. The KAHPM consists of experts in various fields of health policy and management, and has been the leading academic discussion forum for health policy agendas of interest to the public. Health Policy and Management (HPM), the official journal of the KAHPM, published the first issue of volume 1 in October, 1991 and is publishing the second issue of volume 28 as of 2018. Currently, it is one of Korea' main journals in the field of health policy and management. HPM has published a special issue in commemoration of the 30th anniversary of the KAHPM. The HPM invited authors, including former presidents of the KAHPM and current board members, to write about main issues in health policy and management. Although the HPM tried to set up an invited author on all subjects in the health policy and management field, 19 papers are published, that completed the peer review process by August, 2018. The authors of the special issue of the 30th anniversary of the KAHPM include six former presidents, a senior professor, and 12 board members. The subjects of this issue are reform of the healthcare delivery system, health insurance and medical policy, reform of health system governance, the role of National Health Insurance Service (NHIS), the Korea Institute for Health and Social Affairs (KIHASA) and the National Evidence-based healthcare Collaborating Agency (NECA), ethical aspects of health policy change, regional disparities of healthcare, healthcare accreditation, new healthcare technology evaluation system, globalization of the healthcare industry, the epidemiological investigator system, the quarantine system, safety and disaster, and official development assistance. There are some remaining topics to deal with for the KAHPM: aged society, anti-smoking, non-infectious disease, suicide, healthcare resources, emergency medical care, out-of-pocket money, medical fee payment system, medical aid system, long-term care insurance, industrial accident compensation insurance, community-centered health welfare system, and central government and local government of health. The HPM will continue to publish review articles on the main topics in health policy and management. This is because the KAHPM, which has been the leading academic society of Korea's health policy and management for the last 30 years, feels responsible for continuing its mission for the next 30 years.

• Tuberculosis and Respiratory Diseases
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• v.81 no.1
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• pp.19-28
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• 2018

Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.