Lee Kyeong Soo, Kim Chang Suk, Park Jong Heon, Hwang Tae Yoon, Kim Sang Won, Sim Sung Bo, Lee Kun Sei
Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine.
Department of Dental Hygiene, Ulsan College.
Korean J Thorac Cardiovasc Surg. 2016 Dec;49(Suppl 1):S1-S13. doi: 10.5090/kjtcs.2016.49.S1.S1. Epub 2016 Dec 5.
The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery.
Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013.
There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high.
Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.
本研究旨在调查10年间大都市内外手术及外科医疗服务利用情况的纵向变化,分析患者的居住区域以及主要心血管手术的医疗设施位置。
利用2003年1月至2013年12月期间国民健康保险公团的数据,通过对大城市和省份患者的地址以及医疗设施位置进行分类来进行数据分析。
首尔的医疗设施存在严重的心脏大手术集中现象;随着时间推移,这一问题并未得到改善。根据主要疾病,大都市地区进行的手术程序百分比存在差异。在釜山和大邱省,至少50%的患者在市内的医疗设施接受手术,但在其他地区,这一比例低于50%。在省份方面,首尔或附近大都市城市的医疗设施进行的手术程序百分比非常高。
需要制定政策来加强心脏手术的区域能力并确保人力资源,以缓解首都地区患者的集中情况。必须指定许多区域多中心,以尽量减少区域大学医院之间不必要的竞争,并激活医疗服务的双赢伙伴关系模式。