Regional disparities in emergency retinal surgery: interregional transfer and visual disability in a nationwide population-based study in Korea.

IF 2.4 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Epidemiology and Health Pub Date : 2026-10-02 DOI:10.4178/epih.e2026053

EunAh Kim, Seonghee Nam

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引用次数: 0

Abstract

Objectives: To assess regional disparities in access to emergency surgery for rhegmatogenous retinal detachment (RRD) in South Korea and the association between interregional patient transfer and long-term visual disability.

Methods: We used the Health Insurance Review and Assessment Service database to identify 54,269 patients aged ≥11 years who underwent RRD surgery within 30 days of diagnosis during 2014-2023. Interregional transfer was defined as discordance between the regions of residence and surgery across 6 administrative regions. Logistic regression and Cox proportional hazards models were used to assess associations of transfer with reoperation and visual disability registration, adjusting for demographic characteristics, comorbidities, and socioeconomic factors.

Results: Overall, 5,224 patients (9.6%) underwent interregional transfer; 76.4% traveled to the Seoul metropolitan area, the only net recipient region (+12.2%). Jeju (-38.6%) and Gangwon (-28.8%) had the greatest outflow. Transfer was associated with a higher risk of visual disability (adjusted hazard ratio, 1.4; 95% confidence interval: 1.2-1.7; P < 0.001), but not with reoperation (P = 0.960). Surgical delay was more frequent among transferred patients (42.0% vs 33.6%; P < 0.001). Jeju's net outflow decreased from -69.8% in 2018 to -2.6% in 2023.

Conclusion: Despite universal health insurance, regional disparities in access to retinal surgery persist in Korea, with services concentrated in the Seoul metropolitan area. Transfer was independently associated with visual disability but not reoperation. The underlying mechanism likely involves referral of complex cases, patient preference, and transfer-related delay, although claims data cannot distinguish their relative contributions. Jeju's rapid improvement in self-sufficiency illustrates the potential for targeted regional investment to reduce these disparities.

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急诊视网膜手术的地区差异：韩国一项全国性人群研究中的区域间转移和视力障碍。

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来源期刊

Epidemiology and Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.30

自引率

2.60%

发文量

106

审稿时长

4 weeks

期刊介绍： Epidemiology and Health (epiH) is an electronic journal publishing papers in all areas of epidemiology and public health. It is indexed on PubMed Central and the scope is wide-ranging: including descriptive, analytical and molecular epidemiology; primary preventive measures; screening approaches and secondary prevention; clinical epidemiology; and all aspects of communicable and non-communicable diseases prevention. The epiH publishes original research, and also welcomes review articles and meta-analyses, cohort profiles and data profiles, epidemic and case investigations, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.