Kim Myunghwa, Yoon Seok-Jun, Choi Ji Suk, Kim Myo Jeong, Sim Sung Bo, Lee Kun Sei, Chee Hyun Keun, Park Nam Hee, Park Choon Seon
Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine.
Korean J Thorac Cardiovasc Surg. 2016 Dec;49(Suppl 1):S14-S19. doi: 10.5090/kjtcs.2016.49.S1.S14. Epub 2016 Dec 5.
This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions.
This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service. We identified developments over the 5-year time period and analyzed the level of regional imbalance regarding cardiovascular surgery through the relative comparison of relevance indexes between cardiovascular and other types of surgery.
The relevance index was high in large cities such as Seoul, Daegu, and Gwangju, but low in regions that were geographically far from the capital area, such as the Gangwon and Jeju areas. Relevance indexes also fell as the years passed. Cardiovascular surgery has a relatively low relevance index compared to key types of surgery of other fields, such as neurosurgery and colorectal surgery.
This study identified medical service use imbalance between regions for cardiovascular surgery. Results of this study demonstrate the need for political intervention to enhance the accessibility of necessary special treatment, such as cardiovascular surgery.
本研究使用关联指数来了解心血管外科区域医疗服务利用状况，并识别地区间医疗服务利用的不均衡情况。
本研究利用来自政府行政和内政部的居民登记地址数据，以及来自健康保险审查和评估服务机构的2010 - 2014年健康保险、医疗救助和医疗福利索赔数据，计算了16个大城市和省份的关联指数。我们确定了5年期间的发展情况，并通过比较心血管外科与其他类型外科手术的关联指数，分析了心血管外科区域不均衡的程度。
关联指数在首尔、大邱和光州等大城市较高，但在离首都地区较远的地区，如江原道和济州地区较低。随着时间的推移，关联指数也有所下降。与其他领域的关键类型手术，如神经外科和结直肠外科相比，心血管外科的关联指数相对较低。
本研究识别了心血管外科区域间医疗服务利用的不均衡情况。本研究结果表明需要进行政策干预，以提高必要的特殊治疗（如心血管外科手术）的可及性。
