Health Policy Manag.  2022 Jun;32(2):205-215. 10.4332/KJHPA.2022.32.2.205.

Factors Influencing Medical Care Utilization according to Decline of Region: Urban Decline Index and Medical Vulnerability Index as Indicators

• Jeong JY
• Jeong JY
• Yoon IH
• Choi HY
• Lee HJ

• KMID: 2534953
• DOI: http://doi.org/10.4332/KJHPA.2022.32.2.205

Abstract

Background
The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators.
Methods
This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables.
Results
There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect.
Conclusion
The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

Keyword

Healthcare disparities; Health services accessibility; Vulnerable area; Urban decline; Medical care utilization