Journal of the Korean Geographical Society (대한지리학회지)

The Korean Geographical Society (대한지리학회)
권호 표지

Distribution Characteristics of the Medical Services in Korea

한국 의료서비스의 분포 특징 분석

  • Lee Keumsook (Department of Geography, Sungshin Women's University)
  • Published : 2005.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

This study investigates the distribution characteristics of medical services in Korea. For the purpose this paper examines the spatial discordance between the provisions of the medical services and the need for them, and analyzes the spatial distribution patterns of medical service in both inter- and intra-regional levels. Disclosed is a severe regional disparity problem in the provision of medical facilities at both inter-regional and intra-regional levels. In recent years people's interest gets increased more in the social well-being of the community, and the resulting strong request makes it desirable to restructure the healthcare service system. This study has thus attempted to draw out the distribution function of the medical facilities, based on the examination of the real data. A particular attention has been paid to whether there exists any hierarchical structure in their size distribution. Quite remarkably, no appreciable hierarchical structure has been observed in the scale of the medical facilities in Korea, in sharp contrast to of the three-level hierarchical structure assumed in the three-level referral system adopted widely. Remarkably, it is revealed that medical facilities in Korea are described by scale-invariant distribution functions. Instead, scale-invariant power-law behavior has been found in the size distribution, which is expected to be rather generic and applicable to other countries as well.

본 연구에서는 우리나라 의료서비스의 공간분포에 나타나는 특징을 분석하였다. 이를 위하여 의료서비스의 공간적 분포 패턴을 조사하고, 의료 서비스에 대한 수요에 대한 공급의 공간적 패턴 분석을 통하여 의료서비스 공급에 나타나는 공간적 격차문제를 지역간과 지역내의 수준에서 분석하였다. 분석 결과 인구수를 고려한 상태에서도 의료 서비스의 공급이 대도시 및 경제적 중심지에 집중 분포하고, 촌락 및 경제적 주변지역은 크게 미흡한 상태여서 공간적 격차가 매우 심하다. 이러한 공간적 격차는 하나의 도시 내에서도 나타나고 있음을 확인하였다. 또한 본 연구에서는 병원시설의 규모별 분포 수의 관계를 분석하였다. 병원시설의 규모와 분포수의 관계는 기존의 병원시설 입지계획 모형들이 일반적으로 가정하는 계층적 구조보다는 자연계 및 사회 현상의 분포에 일반적으로 나타나는 보편적 질서로 밝혀진 법칙과 유사한 분포 함수를 보인다. 즉, 병원 규모에 따른 분포에 격차가 나타나지 않는 것으로 나타나고 있다. 이는 우리나라 의료체계가 3단계로 구분되어 있음에도 불구하고 병원시설의 분포는 규모에 뚜렷한 격차를 나타내지 않는 것을 의미한다. 이러한 병원시설의 규모와 분포 수가 보이는 특징은 의료서비스의 공간적 분포가 보여 주는 특징과 함께 앞으로 바람직한 의료서비스 시설 입지계획을 위한 모형 정립에 유용한 정보로 이용될 수 있다.

Keywords

References

  1. Anderson, C., Hellervik A., Lindgren, K., Hagson, A., and Tomberg, J., 2003, The urban economy as a scale-free network, e-print cond-mat /03035352
  2. Bak, P., 1999, How Nature Works: The Structure of Self-Organized Criticality, Springer-Verlag, New York
  3. Blank, A. and Solomon, S., 2000, Power laws in cities population, financial markets and internet sites (scaling in systems with a variable number of components), Physica A, 287, 279-288 https://doi.org/10.1016/S0378-4371(00)00464-7
  4. Buxton, M. and Klein, R., 1975, Distribution of hospital provision: Policy themes and resource variations, British Medical Journal, 1, 345-349
  5. Choi, MY., Lee, H.Y., Kim, D., and Park, S.H., 1997, Entropic sampling and natural selection in biological evolution, Journal of Physics A, 30, L749-L755 https://doi.org/10.1088/0305-4470/30/22/002
  6. Choi, M.Y., Kim, B.J., Yoon, B.-G., and Park, H., 2005, Information transfer and self-organized criticality, Europhysics Letters, 69, 503-509 https://doi.org/10.1209/epl/i2004-10375-2
  7. Congdon, P., 2000, A Bayesian approach to prediction using the gravity model, with an application to patient flow modeling, Geographical Analysis, 32(3), 205-224 https://doi.org/10.1111/j.1538-4632.2000.tb00425.x
  8. Coates, B. and Rawstron, E., 1971, Regional Variations in Britain, Batsford, London
  9. Gober, P. and Gordon, R.J., 1980, Intraurban physician location: a case study of Phoenix, Social Science and Medicine, 14D, 407-417
  10. Gould, M. and Moon, G., 2000, Problems of providing health care in British island communities, Social Science and Medicine, 50, 1081-1090 https://doi.org/10.1016/S0277-9536(99)00356-1
  11. Gould, S.J. and Eldredge, N., 1993, Punctuated equilibrium comes of age, Nature, 366, 223-227 https://doi.org/10.1038/366223a0
  12. Handerson, J.V., 1985, Economic Theory and the Cities, Academic Press, San Diego
  13. Hart, J.T., 1971, The inverse care law, Lancet, 1, 405-412 https://doi.org/10.1016/S0140-6736(02)95376-6
  14. Haynes, R., 1991, Inequalities in health and health service use: evidence from the General Household Survey, Social Science & Medicine, 33, 361-368 https://doi.org/10.1016/0277-9536(91)90317-6
  15. Health Resources Policy Division, 1976, 1981, 1986, 1996, 2001, Annual Statistics of the Ministry of Health and Welfare
  16. Jones. K. and Moon, G., 1993, Medical geography: taking space seriously, Progress in Human Geography, 17, 515-524 https://doi.org/10.1177/030913259301700405
  17. Joseph, A. and Phillips, D., 1984, Accessibility and Utilization: Geographical Perspectives on Health Care Delivery, Harper and Row, New York
  18. Kaizoji, T., 2003, Scaling behavior in land markets, Physica A, 326, 256-264 https://doi.org/10.1016/S0378-4371(03)00145-6
  19. Kim, H. and Lee, K., 1998, The relationships between hospital distribution and socio-economic indices in Seoul, The Journal of Applied Geography, 21, 17-37
  20. Knox P.L., 1982, The geography of medical care delivery: An historical perspective, Geoforum, 12, 245-250
  21. Lee, K., 1998, The medicare service facility location problem, Journal of the Economic Geographical Society of Korea, 1(2), 71-84
  22. Makes, H.A., Havlin, S., and Stanley, H.E., 1995, Modeling urban growth patterns, Nature, 377, 608-612 https://doi.org/10.1038/377608a0
  23. Melescio, G., Dokholyan, N.V., and Stanley, H.E., 2000, Hierarchical organization of cities and nations, e-print cond-mat/0005178
  24. Mohan, J.F., 1998, Explaining geographies of health care: A critique, Health and Place, 4, 113-124 https://doi.org/10.1016/S1353-8292(98)00004-5
  25. Morrill, R.L. and Erickson, R.J., 1969, Location efficiency in Chicago hospitals, Health Sennces Research, 4, 127-145
  26. Morrill, R. and Rees, P., 1967, Physician referral and patient to hospital flows, Chicago Regional Hospital Study Working Paper, 1 (11), Chicago
  27. Mustard, J.F. and Frank, J., 1994, The determinants of health, in Hayes, M.V. et al.Ceds.), The Determinants of Population Health: A Critical Assessment, Western Geographical Series, 29, 748
  28. Noyce, J., Snaith, A.H. and Trickey, A., 1974, Regional variations in the allocation of financial resources to the community health services, Lanset, 1, 554-557
  29. Powell, M., 1990, Need and provision in the National Health Service: an inverse care law, Policy and Politics, 18, 31-37 https://doi.org/10.1332/030557390782454657
  30. Shannon, G.W. and Dever, G.E.A., 1974, Health Care Delivery-Spatial Perspectives, McGraw-Hill, New York
  31. The Korean Medical Doctors Association, 1991, 2001, Survey Reports for the Memberships
  32. Townsend, P. and Davidson, N. and Whitehead, M., 1992, Inequalities in Health: the Black Report and the Health Divide, Penguin, Harmondsworth
  33. West, R. and Lowe, C., 1976, Regional variations in need for and provision and use of child health services in England and Wales, British Medical Journal, 2, 843-846 https://doi.org/10.1136/bmj.2.6040.843
  34. Zanette, D.H. and Manrubia, S.C, 1997, Role of intermittency in urban development: a model of large-scale city formation, Physical Review Letters, 79, 523-526 https://doi.org/10.1103/PhysRevLett.79.523
  35. Zipf., G.K, 1949, Human Behavior and the Principle of Least Effort, Addison-Wesley, Reding