Koh Hyeonseok, Kwon Soonman, Cho Belong
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Graduate School of Public Health, Seoul National University, Seoul, Korea.
Korean J Fam Med. 2024 Mar;45(2):105-115. doi: 10.4082/kjfm.23.0156. Epub 2024 Jan 30.
Primary care physicians perform a comprehensive role by providing continuous, patient-centered, and accessible healthcare and establishing connections with specialized care. However, the association between the supply of primary care physicians and mortality rates in South Korea has not been thoroughly investigated.
This study utilized data from 229 si-gun-gu in South Korea from 2016 to 2020. The densities of primary care physicians, physicians in functional primary clinics, specialists in primary care facilities, and active physicians per 100,000 people were independent variables. Age-adjusted all-cause mortality and cause-specific mortality rates per 100,000 individuals were the dependent variables. Negative binomial regression, negative binomial regression with a pseudo-panel approach, and geographically weighted regression were used to analyze the data.
Our study revealed a significant negative association between the density of primary care physicians and all-cause mortality. An increase in a primary care physician per 100,000 population was significantly linked to a 0.11% reduction in all-cause mortality (incidence rate ratio, 0.9989; 95% confidence interval, 0.9983-0.9995). Similar associations have been observed between mortality rates owing to cardiovascular diseases, respiratory tract diseases, and traffic accidents.
This study provides evidence that having a higher number of primary care physicians in South Korea is associated with lower mortality rates. Future research should consider better indicators that reflect the quality of primary care to better understand its impact on population health outcomes. These findings emphasize the significance of strengthening primary care in the South Korean healthcare system to improve the overall health and wellbeing.
基层医疗医生通过提供持续、以患者为中心且可及的医疗服务,并与专科医疗建立联系,发挥着全面的作用。然而,韩国基层医疗医生的供应与死亡率之间的关联尚未得到充分研究。
本研究利用了韩国229个市郡区2016年至2020年的数据。每10万人中基层医疗医生、功能性基层诊所医生、基层医疗设施专科医生和在职医生的密度为自变量。每10万人中年龄调整后的全因死亡率和特定病因死亡率为因变量。采用负二项回归、伪面板方法的负二项回归和地理加权回归对数据进行分析。
我们的研究揭示了基层医疗医生密度与全因死亡率之间存在显著的负相关。每10万人口中基层医疗医生数量的增加与全因死亡率降低0.11%显著相关(发病率比,0.9989;95%置信区间,0.9983 - 0.9995)。在心血管疾病、呼吸道疾病和交通事故导致的死亡率之间也观察到了类似的关联。
本研究提供了证据,表明韩国基层医疗医生数量较多与较低的死亡率相关。未来的研究应考虑更好地反映基层医疗质量的指标,以更好地理解其对人群健康结果的影响。这些发现强调了加强韩国医疗体系中基层医疗以改善整体健康和福祉的重要性。