Socioeconomic Equity in Regional Distribution of Health Care Resources in Korea

Boyoung Jeon, Su Min Choi, Chang-yup Kim
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引用次数: 13

Abstract

One of the ways to achieve the principle of equal access for equal needs, availability and geographical accessibility of health care resources regardless of resident sites is important. The purpose of this paper is to measure socioeconomic inequities in distribution of health care resources among regions in the Republic of Korea (hereafter Korea). Data were extracted from regional statistics of National Health Insurance, Community Health Survey, Korea Social Science Data Archive, and Korean Statistical Information Services at the same period of 2009. The dependent variables were the number of health workforce and health care facilities in each region. The proxy indicator of regional socioeconomic status was local tax per person. To identify whether inequalities among regions, we examined the concentration index(CI) and indirectly standardized CI by controlling each region`s demographics and need factors. Total observations were 232 districts in nationwide, and we analyzed separately Seoul(25 districts) and non-Seoul areas(207 districts). The standardized CI values of health care resources were positive(favoring the rich region) across the nation in almost all kinds of resources. Especially the number of specialist, dentist, dental clinics, clinics, oriental medical clinics, pharmacists, and pharmacies were statistically significantly favoring the rich region. But the CI for the number of long-term care hospitals, public health centers were negative(favoring the poor region). The tendency of CI presenting positive values were increased in Seoul area. But in the case of non-Seoul, the CI indexes were nearly zero. The results suggest that except the Seoul area, little regional socioeconomic-related inequalities were observed in the distribution of health care resources in Korea.
韩国医疗资源区域分配的社会经济公平
实现卫生保健资源的平等需求、可获得性和地理可及性原则的途径之一是重要的,而不论居住地点如何。本文的目的是衡量大韩民国(以下简称韩国)地区之间卫生保健资源分配的社会经济不平等。数据提取自2009年同期国民健康保险、社区健康调查、韩国社会科学数据档案和韩国统计信息服务的地区统计数据。因变量是每个地区卫生人力和卫生保健设施的数量。地区社会经济地位的代理指标是人均地方税收。为了确定地区之间是否存在不平等,我们检查了集中度指数(CI),并通过控制每个地区的人口统计和需求因素间接标准化了CI。我们以全国232个地区为对象,分别分析了首尔地区(25个)和非首尔地区(207个)。全国几乎所有资源的卫生保健资源标准化CI值均为正(向富裕地区倾斜)。特别是专科医生、牙医、牙科诊所、诊所、东方医学诊所、药剂师和药店的数量在统计上明显偏向富裕地区。但长期护理医院、公共卫生中心数量的CI为负(有利于贫困地区)。首尔地区CI呈现正值的趋势有所增加。但在非首尔地区,CI指数几乎为零。结果表明,除首尔地区外,韩国医疗资源分配的区域社会经济不平等现象较少。
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