Song Yun Seob, Shim Sung Ryul, Jung Insoo, Sun Hwa Yeon, Song Soo Hyun, Kwon Soon-Sun, Ko Young Myoung, Kim Jae Heon
Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2015 Nov;30(11):1638-45. doi: 10.3346/jkms.2015.30.11.1638. Epub 2015 Oct 16.
The adequacy of the urologist work force in Korea has never been investigated. This study investigated the geographic distribution of urologists in Korea. County level data from the National Health Insurance Service and National Statistical Office was analyzed in this ecological study. Urologist density was defined by the number of urologists per 100,000 individuals. National patterns of urologist density were mapped graphically at the county level using GIS software. To control the time sequence, regression analysis with fitted line plot was conducted. The difference of distribution of urologist density was analyzed by ANCOVA. Urologists density showed an uneven distribution according to county characteristics (metropolitan cities vs. nonmetropolitan cities vs. rural areas; mean square=102.329, P<0.001) and also according to year (mean square=9.747, P=0.048). Regression analysis between metropolitan and non-metropolitan cities showed significant difference in the change of urologists per year (P=0.019). Metropolitan cities vs. rural areas and non-metropolitan cities vs. rural areas showed no differences. Among the factors, the presence of training hospitals was the affecting factor for the uneven distribution of urologist density (P<0.001). Uneven distribution of urologists in Korea likely originated from the relatively low urologist density in rural areas. However, considering the time sequencing data from 2007 to 2012, there was a difference between the increase of urologist density in metropolitan and non-metropolitan cities.
韩国泌尿科医生人力的充足程度从未得到过调查。本研究调查了韩国泌尿科医生的地理分布情况。在这项生态学研究中，分析了来自国民健康保险服务局和国家统计局的县级数据。泌尿科医生密度的定义是每10万人中泌尿科医生的数量。使用地理信息系统（GIS）软件在县级层面以图形方式绘制了泌尿科医生密度的全国分布图。为了控制时间序列，进行了带拟合线图的回归分析。通过协方差分析（ANCOVA）分析了泌尿科医生密度分布的差异。泌尿科医生密度根据县的特征（大城市与非大城市与农村地区）以及年份呈现出不均衡分布（均方=102.329，P<0.001），且根据年份也存在差异（均方=9.747，P=0.048）。大城市与非大城市之间的回归分析显示每年泌尿科医生数量的变化存在显著差异（P=0.019）。大城市与农村地区以及非大城市与农村地区之间未显示出差异。在这些因素中，培训医院的存在是泌尿科医生密度不均衡分布的影响因素（P<0.001）。韩国泌尿科医生的不均衡分布可能源于农村地区相对较低的泌尿科医生密度。然而，考虑到2007年至2012年的时间序列数据，大城市和非大城市泌尿科医生密度的增长存在差异。
