• 보건행정학회지
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• 제3권2호
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• pp.81-99
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• 1993

The purpose of this research is to assess the geographical distribution of physicians and dentists and the degree of maldistribution of the physician. Data were obtained form the Korean Medical Association's report on physicians registry and census for 1990. To assess the degree of disparity in the rural-urban distribution of physician manpower and to identify changes in the distribution pattern, the Gini index of concentration was used. Major findings are as follows; 1. Urban-rural disparity in the distribution of physician manpower exists in all categories of manpower, i.e. physician, dentist, oriental medical doctor, general practitioner, medical specialist, practitioner, public health physician and public health dentist. Urban area which had 74.4% of nation's population, accounted for over 90% of all physician manpower. 2. In terms of the ration of physician manpower per 10, 000 population, in urban area, they were 8.2 physicians, 2.7 general practitioners, 5.5 specialists, 3.0 practitioners, 1.8 dentists and 1.3 oriental medical doctors. In rural area, the ratios were 1.4 physicians, 0.6 general practitioners, 0.9 specialists, 1.0 practitioners, 0.4 dentists and 0.4 oriental medical doctors. 3. Gini indicies computed to measure inequality of physician manpower distribution were 0. 3675 for physicians, 0.3372 for general practitioners, 0.3338 for specialists, 0.2263 for practitioners, 0.3132 for dentists and 0.3293 for oriental medical doctors. 4. Inspite of increase in the number of physician manpower, urban concentration of physician manpower intensified from 1980 to 1990. However, the Gini index for all physician manpower fell by 18.3~36.7% from 1980 to 1990, indicating more even distribution. 5. In rural area, the public health physicians and dentists had increased the ratios of physicians, general practitioners, practitioners and dentists per 10, 000 population remarkebly, and had decreased the Gini indicies of physicians, general practitioners, practitioners and dentists. Thus, public health physicians and dentists contributed to improve the distribution of physician manpower in rural area. Based on the results of this study, long-term and rational manpower policies should be developed to solve the problem of geographical maldistribution of physician manpower as well as short-term policy for inducing physicians to the rural areas.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.661-671
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• 1993

In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.429-437
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• 1996

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.

• 보건행정학회지
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• 제2권1호
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• pp.17-41
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• 1992

During the month of October, 1990, 676 practicing physicians in Taegu City were surveyed by mail questionnaires about their general characteristics and the reasons why they chose Taegu as a practice location and 331 out of them responded completely. Collected data were analyzed to provide basic reference data for future health manpower policy which intends to solve the problem of geographical maldistribution of physicians, The major findings are as follows: For the question asking why Taegu area is favored, following lists are as the order of their magnitude of the reasons replied by more than 20% of the respondents: 1) Taegu is a foundation of life until now(81.3%) 2) Better educational environments are available for their offsprings(73.7%) 3) They can have intimate relationship with acquaintances or friends sharing same or similar interests(61.0%) 4) Due to characteristics of their specialty, metropolitan seems to fit better(52.0%), 5) They graduated from the medical school in Taegu(49.8%) 6) Never thought of selecting practice location in other area than Taegu without any specific reasons(45.9%) 7) Intelligent communications are available with other physicians(39.9%) 8) More opportunities to participate in social life, such as medical, or alumni association etc., can be given(33.2%) 9) No specific knowledge or relationships with other area are available(32.6%) 10) They finished internship or residency training in Taegu area(31.4%) 11) Facilitation of transferring patients including emergent patients can be obtained (30.8%) 12) Continuing medical educational programs are available(29.9%) 13) Sufficient medical demands are provided because of the large population(28.1%) 14) More chances to be grown up as a medical professionals can be achieved(25.7%) 15) More leizure time can be utilized for cultural activities(23.9%) 16) They had experiences to work in hospitals or facilities in Taegu area(23.3%) 17) Medical facilities of fellow physicians or alumni can be used(20.5%) In addition, 37% of female physicians answered that their spouse strongly influenced them to choose Taegu, and 33.3% of physicians with age of thirty replied that parents did so. Physicians of specialty in radiology, clinical pathology, anatomical pathology, and anesthesiology considered that patients from other hospitals and medical facilities would be referred often to them and that less competition seemed to be expected in their specialty (30.8%). In contrast, general practitioners anticipated that larger population would increase the medical demand(62.5%). 28.6% of medical practitioners who graduated medical schools in other are than Taegu and 22.0% of medical practitioners who were trained in hospitals of other area than Taegu were influenced to choose Taegu by their spouses. In consideration of above findings, we may conclude that long term and rational manpower policies should be implemented to solve the problem of geographical maldistribution of physicians as well as short term physician-inducing policies, and they have to be incorporated with equitable community development.

• Journal of Preventive Medicine and Public Health
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• 제20권2호
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• pp.301-311
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• 1987

의사들의 지역간 분포양상 및 불균형 정도를 체계적으로 측정하여, 장기적이고 합리적인 의사인력의 배분정책 수립을 위한 기초자료로 제시하고자 1980년과 1985년의 인구센서스 통계자료와 정기의사 신고자료를 이용하여 의사, 일반의, 전문의의 지역간 불균형정도를 분석한 결과는 다음과 같다. 1980년에는 전체의사의 10.4%가 군지역에 위치하고 있었으나 1985년에는 9.6%로 군지역 분포율이 낮아졌고, 인구 100,000명당 의사수는 1980년에는 군지역에 9.18명이던 것이 1985년에는 12.95명으로 증가했다. 일반의는 1980년에 군지역에 14.7% 분포되어 있었으나 1985년에는 12.7%로 낮아졌고, 인구 100,000명당 의사수는 7.13에서 7.29명으로 증가했다. 전문의의 경우 1980년에는 5.1%가 군지역에 위치하고 있었으나 1985년에는 7.3% 증가되었고, 인구 100,000명당 의사수도 2.05명에서 5.66명으로 증가했다. 군지역에의 분포비율이 10%를 초과한 전문과목별 전문의는 일반외과와 예방의학과 뿐이었으며, 1980년에 비해 1985년에 군지역 분포비율이 흉부외과 전문의를 제외하고는 모든 전문과목에서 높아졌다. Gini계수의 1980년$\sim$1985년간 변화율은 의사 -15.40%, 일반의 18.01%, 전문의 -10.43%로서 일반의의 불균형 정도가 심화되었고, 구지역간과 군지역간에는 모든 의사의 분포가, 시지역간에는 일반의의 분포만 더 불균형하게 된 것으로 나타났다. 전문의 중에서는 소아과 전문의의 변화율이 -12.24%로 가장 높았으며, 신경외과, 흉부외과, 성형외과, 안과, 결핵과, 예방의학과, 해부병리과 전문의는 1980년보다 1985년에 Gini계수가 더 높아졌다. 그리고 1985년 기준으로 일반외과 전문의의 Gini계수만 0.4369로 0.5이하였고, 0.8이상인 전문과목은 성형외과, 결핵과, 임상병리과, 해부병리과, 재활의학과 등이었다. 의사의 지역간 균형분포를 위해서는 의사의 지역간 분포요인 분석 연구를 통해, 이를 기초로 적절한 배분정책을 수립해야 할 것이며, 공공의료인력의 효과적인 활용이 필요할 것으로 보인다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7219-7229
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• 2015

Background: Chromosomal aberrations identified in acute lymphoblastic leukemia (ALL) have an important role in disease diagnosis, prognosis and management. Information on karyotype and associated clinical parameters are essential to physicians for planning cancer control interventions in different geographical regions. Materials and Methods: In this study, we present the overall frequency and distribution patterns of chromosomal aberrations in both children and adult de novo B lineage ALL Indian patients using conventional cytogenetics, interphase FISH and multiplex RT-PCR. Results: Among the 215 subjects, cytogenetic results were achieved in 172 (80%) patients; normal karyotype represented 37.2% and abnormal 62.8% with a distribution as follows: 15.3% hypodiploidy; 10.3% hyperdiploidy; 15.8% t(9;22); 9.8% t(1;19); 3.7% t(12;21); 2.8% t(4;11); 2.8% complex karyotypes. Apart from these, we observed several novel, rare and common chromosomal rearrangements. Also, FISH studies using LSI extra-signal dual-color probes revealed additional structural or numerical changes. Conclusions: These results demonstrate cytogenetic heterogeneity of ALL and confirm that the incidence of chromosomal abnormalities varies considerably. To the best of our knowledge, this is one of the largest reported series of cytogenetic investigations in Indian B-lineage ALL cases. In addition, ongoing cytogenetic studies are warranted in larger groups of B-lineage ALL cases to identify newly acquired chromosomal abnormalities that may contribute to disease diagnosis and management.