ABSTRACT
OBJECTIVE: In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea. METHODS: Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas. The number of doctors and neurosurgeons per 100000 populations in each county unit was calculated using the total number of doctors and neurosurgeons at the country level from 2009 to 2015. The density levels of neurosurgeon and doctor were calculated and depicted in maps. RESULTS: Between 2009 and 2015, the number of neurosurgeons increased from 2002 to 2557, and the ratio of neurosurgeons per 100000 populations increased from 4.02 to 4.96. The number of neurosurgeons per 100000 populations was highest in metropolitan cities and lowest in rural areas from 2009 to 2015. A comparison of the geographic distribution of neurosurgeons in 2009 and 2015 showed an increase in the regional gap. The neurosurgeon density was affected by country unit characteristics (p=0.000). CONCLUSION: Distribution of neurosurgeons throughout Korea is uneven. Neurosurgeons are being increasingly concentrated in a limited number of metropolitan cities. This phenomenon will need to be accounted when planning for a supply of neurosurgeons, allocation of resources and manpower, and the provision of regional neurosurgical services.
Subject(s)
Geographic Mapping , Health Workforce , Health Services Accessibility , Hospital Distribution Systems , Korea , Neurosurgeons , Neurosurgery , Resource AllocationABSTRACT
OBJECTIVE: In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea.METHODS: Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas. The number of doctors and neurosurgeons per 100000 populations in each county unit was calculated using the total number of doctors and neurosurgeons at the country level from 2009 to 2015. The density levels of neurosurgeon and doctor were calculated and depicted in maps.RESULTS: Between 2009 and 2015, the number of neurosurgeons increased from 2002 to 2557, and the ratio of neurosurgeons per 100000 populations increased from 4.02 to 4.96. The number of neurosurgeons per 100000 populations was highest in metropolitan cities and lowest in rural areas from 2009 to 2015. A comparison of the geographic distribution of neurosurgeons in 2009 and 2015 showed an increase in the regional gap. The neurosurgeon density was affected by country unit characteristics (p=0.000).CONCLUSION: Distribution of neurosurgeons throughout Korea is uneven. Neurosurgeons are being increasingly concentrated in a limited number of metropolitan cities. This phenomenon will need to be accounted when planning for a supply of neurosurgeons, allocation of resources and manpower, and the provision of regional neurosurgical services.
Subject(s)
Geographic Mapping , Health Workforce , Health Services Accessibility , Hospital Distribution Systems , Korea , Neurosurgeons , Neurosurgery , Resource AllocationABSTRACT
Cross-sectional descriptive study with a quantitative approach, whose objectives were to identify those responsible for the care of sterilized healthcare products after their distribution to inpatient units, structural and material resources available for transportation and storage, and to describe the care given to transport and storage of sterilized healthcare products in inpatient units, and the occurrence of events related to these products. Data were collected by checklist in a large teaching hospital from July to September 2012, completed by direct observation and interviews with nursing managers. After descriptive analysis, none of the 11 units met all recommendations concerning the structure, material resources or work processes for the transport and storage of sterilized healthcare products. Events related revealed lack of care of the healthcare teams in the units, and consequent risk to maintaining product sterility and patient safety.
Estudio descriptivo transversal, con abordaje cuantitativo cuyos objetivos eran identificar los responsables de los cuidados requeridos por Productos Sanitarios después de su distribución en unidades de hospitalización, y los aspectos estructurales y recursos materiales disponibles para su transporte y almacenamiento; describir cuidados entregados en el transporte y almacenamiento de Productos Sanitarios en unidades de hospitalización, eincidencia de eventos relacionados con esos productos. Los datos fueron recolectados en un hospital clínico de gran tamaño, entre julio y septiembre de 2012, a través de un checklist, llenado con observación directa y entrevistas a los gerentes de enfermería. Después de un análisis descriptivo, ninguna de las 11 unidades observó todas las recomendaciones referentes a estructura, recursos materiales y procesos de trabajo para el transporte y almacenamiento de los productos. Los eventos relacionados observados revelaron descuidos por parte del equipo de salud en unidades, y el consiguiente riesgo en la mantención de la esterilidad de productos y seguridad del usuario.
Estudo transversal, descritivo com abordagem quantitativa, cujos objetivos foram identificar os responsáveis pelos cuidados com os produtos para saúde, após a sua distribuição nas unidades de internação, e os aspectos estruturais e recursos materiais disponíveis para o seu transporte e armazenamento; descrever os cuidados dispensados com o transporte e armazenamento de produtos para saúde, nas unidades de internação e a ocorrência de eventos relacionados com esses produtos. Os dados foram coletados em um hospital de ensino de grande porte, de julho a setembro de 2012, por um checklist, preenchido por observação direta e uma entrevista com os gerentes de enfermagem. Após análise descritiva, nenhuma das 11 unidades atendia a todas as recomendações referentes à estrutura, recursos materiais e processos de trabalho para o transporte e armazenamento dos produtos. Os eventos relacionados observados revelaram descuidado da equipe de saúde nas unidades e consequente risco para a manutenção da esterilidade dos produtos e segurança do usuário.
Subject(s)
Humans , Perioperative Nursing , Sterilization , Hospital Distribution Systems , Materials Management, HospitalABSTRACT
PURPOSE: In Korean society, extra-large hospitals are congested with the majority of patients. Because of the congestions, the urgent patients need to wait anywhere from as short as a month to around three months. These concentrations of the patients on the extra-large hospitals causes not only the economic problem in terms of loss of opportunity cost and resources of other medium and large hospitals but also the fear and the consequential stress of the patients and the families of the patients who are waiting for the surgeries. The phenomenon of the concentrations derived due to the insufficient information to the medical consumers. If the information on medical treatment services such as surgery schedule is provided before the selection of hospital, we expect that the selection of hospital for the patients and their family will differ, resulting in redistribution of concentration phenomenon. In this paper, we propose and verify the effective distribution system for the concentration on the extra-large hospitals. METHODS: Web simulation survey was conducted. A total 100 respondents were divided into 4 groups of 25 respondents and the different information was provided to each group. RESULTS: Through multiple comparisons among groups, only group which was provided with both information about 'the difference of surgical results' and 'the waiting time for surgery', had difference in significance. CONCLUSION: By providing two sets of information to patients, reckless selection of extra-large hospitals can be spread to more appropriate hospitals and therefore achieve effective distribution of the population concentration on extra-large hospital.