The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization

김민주; 박종헌; 강성찬; 황교상; 이태식; 김윤

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자료유형: 학술저널

저자정보: 김민주 박종헌 강성찬 황교상 이태식 김윤

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제49권 제4호

발행연도: 2016.1

수록면: 230 - 239 (10page)

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Objectives: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. Methods: To compare geographic variation in geographic units of analysis, we calculated the age–sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. Results: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. Conclusions: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

#Small-area analysis #Delivery of health care #Utilization

참고문헌 (32)

참고문헌 신청

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