J Korean Med Sci.  2015 Nov;30(11):1638-1645. 10.3346/jkms.2015.30.11.1638.

Geographic Distribution of Urologists in Korea, 2007 to 2012

• Song YS
• Shim SR
• Jung I
• Sun HY
• Song SH
• Kwon SS
• Ko YM
• Kim JH

• KMID: 2351115
• DOI: http://doi.org/10.3346/jkms.2015.30.11.1638

Abstract

The adequacy of the urologist work force in Korea has never been investigated. This study investigated the geographic distribution of urologists in Korea. County level data from the National Health Insurance Service and National Statistical Office was analyzed in this ecological study. Urologist density was defined by the number of urologists per 100,000 individuals. National patterns of urologist density were mapped graphically at the county level using GIS software. To control the time sequence, regression analysis with fitted line plot was conducted. The difference of distribution of urologist density was analyzed by ANCOVA. Urologists density showed an uneven distribution according to county characteristics (metropolitan cities vs. nonmetropolitan cities vs. rural areas; mean square=102.329, P<0.001) and also according to year (mean square=9.747, P=0.048). Regression analysis between metropolitan and non-metropolitan cities showed significant difference in the change of urologists per year (P=0.019). Metropolitan cities vs. rural areas and non-metropolitan cities vs. rural areas showed no differences. Among the factors, the presence of training hospitals was the affecting factor for the uneven distribution of urologist density (P<0.001).Uneven distribution of urologists in Korea likely originated from the relatively low urologist density in rural areas. However, considering the time sequencing data from 2007 to 2012, there was a difference between the increase of urologist density in metropolitan and non-metropolitan cities.

Keyword

Urology; Manpower; Ecology; Specialties, Surgical

MeSH Terms

Cities/statistics & numerical data
Health Services Accessibility/*statistics & numerical data/trends
Korea/epidemiology
Physicians/*supply & distribution/trends
Republic of Korea/epidemiology
Rural Health Services/*manpower/statistics & numerical data/trends
Rural Population/statistics & numerical data/trends
Urban Health Services/*manpower/statistics & numerical data/trends
Urology/*manpower/*statistics & numerical data/trends

Figure

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  Fig. 1 Geographic distribution urologist density in Korea by GIS in 2007 (A) and 2012 (B).

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  Fig. 2 Fitted plots for urologist density in each country level per year. All country levels showed increasing pattern of urologist density including metropolitan cities (A), cities (B), and countries (C).

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  Fig. 3 Fitted plots for difference of urologist density according to each country level per year. The urologist density increase was significantly different between metropolitan cities and cities (A), whereas it showed no significant difference between metropolitan cities and countries (B), and between cities and countries (C). All country level showed increasing pattern of urologist density including metropolitan cities (A), cities (B), and countries (C).

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  Fig. 4 Fitted plots for relative difference of urologist density according to each country level per year. The relative urologist density increase showed significant difference between metropolitan cities and cities (A), whereas it showed no significant difference between metropolitan cities and countries (B), and between cities and countries (C). All country level showed increasing pattern of urologist density including metropolitan cities (A), cities (B), and countries (C).

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  Fig. 5 Geographic distribution doctor density by GIS in 2006 (A) and 2011 (B).

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