J Prev Med Public Health.
2016 Jul;49(4):230-239. 10.3961/jpmph.16.034.
The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization
- Affiliations
-
- 1Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. yoonkim@snu.ac.kr
- 2Big Data Steering Department, National Health Insurance Service, Wonju, Korea.
- 3Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
- 4Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea.
- KMID: 2348490
- DOI: http://doi.org/10.3961/jpmph.16.034
Abstract
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.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Evaluation of Geographic Indices Describing Health Care Utilization
- Geographic variations in tonsillectomy and adnoidectomy (T & A) and appendectomy in Korea
- Two Cases of Combined Geographic Tongue and Fissured Tongue in Generalized Pustular Psoriasis
- Correlation between Topographic Progression of Geographic Atrophy and Visual Acuity Changes
- An Analysis of Small Area Variations of Hospital Services Utilization in Korea
