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

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.