Relevance Index Regional Variation by Each Disease and Its Essential Medical Field: A Retrospective Data Analysis From 2016-2020 in Korea

Abstract

Background To precisely build a healthcare delivery system at regional levels, local patients’ healthcare service utilization patterns must be examined. Hence, this study utilized trend analysis of the relevance index of each disease of each essential medical service field at the municipal and provincial levels. Methods This study analyzed customized databases released by the National Health Insurance Service from 2016–2020. Diseases defined in the Korean National Burden of Disease (KNBD) study were categorized into the following essential medical service fields: trauma care, cardiocerebrovascular, maternal and neonatal, mental health, infection, cancer, older adults’ care and rehabilitation, and others. Relevance index, the percentage of medical service utilization in a region by the residents of that region relative to their total medical service utilization, was examined by region (17 municipal and provincial regions) and disease area. The relevance index was determined based on the number of patients and the total out-of-pocket expenses. Result Eight of the 17 regions showed over a 90.0% relevance index in the infection area. In the cancer area, 14 regions (not including Seoul, Daegu, and Busan) had a relevance index lower than 75.0%. Throughout the analysis period (2016–2020), there were no significant variations in the relevance index. Diseases such as bone and connective tissue cancer (39.0%), neural tube defects (16.7%), and autism (57.1%) had low relevance index in the essential medical service fields. In all 17 regions, the relevance index of inpatients was lower than that of outpatients, and that for out-of-pocket expenses was lower than that based on the number of patients. Conclusion The relevance index of major diseases of each essential medical service field calculated in this study can provide good indicators for monitoring the level of an independent regional healthcare delivery system.

Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study

“…The relevance index (RI) is highly useful for estimating the demand for healthcare services among local residents and assessing the efficient and equitable distribution of healthcare institutions [ 17 ]. The RI is defined as the ratio between the amount of healthcare services used by patients living in a specific region at medical institutions in that region to the total amount of services used.…”

“…In Korea, previous research related to the accessibility of cardiovascular disease treatment has largely focused on imbalances in the utilization of medical services [ 10 ], emergency medical center accessibility [ 15 , 16 ], and the relevance index for specific diseases [ 17 ]. Limited research has specifically examined geographical variations in the provision of cardiovascular surgery and the associated mortality rates.…”