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与脑部疾病患者选择外地医疗机构就医相关的因素

Factors Associated with the Utilization of Out-of-Region Medical Institutions for Brain Diseases.

作者信息

Go Kyeong-O, Kim Mi-Ji, Hwang Kihwan, Seo Seong-Hyo, Sung Joo Hyun

机构信息

Department of Neurosurgery, College of Medicine, Gyeongsang National University, Jinju, Korea.

Department of Neurosurgery, Gyeongsang National University Changwon Hospital, Changwon, Korea.

出版信息

Yonsei Med J. 2025 Sep;66(9):599-608. doi: 10.3349/ymj.2024.0510.

Abstract

PURPOSE

In South Korea, medical institutions are distributed by region according to the population ratio. However, the utilization rate of out-of-region medical institutions is higher than that of local medical institutions, including among patients with brain diseases requiring surgical intervention. This study aimed to analyze the factors associated with the utilization of out-of-region medical institutions among patients with brain diseases requiring neurosurgical intervention.

MATERIALS AND METHODS

We included data regarding patients with brain disease from the National Health Insurance Service of the Republic of Korea. We analyzed patient-, disease-, and institution-related factors related to the utilization rate of out-of-region medical institutions. Patient-related factors included sex, age, health insurance premiums, impairment status, and underlying disease, while disease- and institution-related factors included treatment method, disease classification, type of medical institution, and region. Statistical analysis was performed using logistic regression.

RESULTS

The utilization rate of out-of-region medical institutions was higher among females, individuals without impairment, individuals with underlying diseases, individuals with high economic status, young patients, and individuals living in non-capital areas. Regarding the disease type, the utilization rate was highest in trauma, followed by tumor, others (infectious, functional brain diseases, etc.), and cerebrovascular disease. For diseases other than cerebrovascular disease, patients requiring surgery had a higher utilization rate compared to those requiring procedures.

CONCLUSION

These findings provide valuable insights into among-group differences in the utilization of medical institutions. Identifying factors that may influence regional concentration in these medical utilization behaviors can provide clues to identifying and improving problems in the allocation of medical resources.

摘要

目的

在韩国,医疗机构按地区人口比例分布。然而,包括需要手术干预的脑部疾病患者在内,外地医疗机构的利用率高于当地医疗机构。本研究旨在分析需要神经外科干预的脑部疾病患者使用外地医疗机构的相关因素。

材料与方法

我们纳入了来自大韩民国国民健康保险服务中心的脑部疾病患者数据。我们分析了与外地医疗机构利用率相关的患者、疾病和机构因素。患者相关因素包括性别、年龄、医疗保险费、损伤状况和基础疾病,而疾病和机构相关因素包括治疗方法、疾病分类、医疗机构类型和地区。使用逻辑回归进行统计分析。

结果

外地医疗机构的利用率在女性、无损伤个体、有基础疾病个体、经济状况良好个体、年轻患者以及居住在非首都地区的个体中较高。就疾病类型而言,创伤的利用率最高,其次是肿瘤、其他(感染性、功能性脑部疾病等)和脑血管疾病。对于脑血管疾病以外的疾病,需要手术的患者比需要其他治疗的患者利用率更高。

结论

这些发现为医疗机构利用方面的组间差异提供了有价值的见解。识别可能影响这些医疗利用行为中地区集中的因素,可以为识别和改善医疗资源分配中的问题提供线索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b25b/12394760/cbd86d695f7b/ymj-66-599-g001.jpg

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