RESUMO
Purpose@#This study aimed to analyze the rate of delivery within the jurisdiction of local governments in Korea. @*Methods@#Information regarding the population, number of women of childbearing age, and number of births was extracted from the Korean Statistics Information Service, National Health Insurance Service, and health map of the National Medical Center. We defined the rate of delivery within the jurisdiction of the local government as the ratio of the number of deliveries delivered by maternity facilities in the region to the total number of deliveries of pregnant women living in the region. @*Results@#The average nationwide delivery rate in the jurisdiction of local governments was 48.0%. The Si area was the highest at 54.9%, and the Gun area was the lowest at 22.1%. Compared to 2014, the national average delivery rate in the jurisdiction decreased by 4.3%; however, the gun area increased by 4.9%. The geographic maternity service area was 122 in 2014; however, this number decreased to 104 in 2020. @*Conclusion@#The national average rate of delivery in the jurisdiction of local governments was 48.0%, and the rate decreased between 2014 and 2020.
RESUMO
Background@#Herein, we aimed to evaluate the maternal mortality ratio and perinatal mortality rate for different perinatal medical care service areas (PMCSAs), which were established by considering their geographical accessibility to maternal-fetal intensive care units (MFICUs) and neonatal intensive care units (NICUs), and to compare the PMCSAs according to their accessibility to these perinatal care services. @*Methods@#Based on the 70 hospital service areas (HSAs) across the country confirmed through the Dartmouth Atlas methodology analysis and gathering of expert opinions, the PMCSAs were designated by merging HSAs without MFICUs and NICUs to the nearest HSA that contained MFICUs and NICUs, based on which MFICU and NICU could be reached within the shortest amount of time from population-weighted centroids in HSAs. PMCSAs where 30% or more of the population could not access MFICUs and NICUs within 60 minutes were identified using the service module ArcGIS and were defined as having access vulnerability. @*Results@#Thirty-three of 70 HSAs in the country did not contain MFICUs and NICUs, and 39 PMCSAs were finally derived by merging 70 HSAs. Ten of 39 PMCSAs (25.6%) were classified as having access vulnerability to MFICUs and NICUs. The national maternal mortality ratio was 9.42, with the highest ratio seen in the region of Wonju (25.86) and the lowest in Goyang (2.79). The national perinatal mortality rate was 2.86, with the highest and lowest rates observed in the Gunsan (4.04) and Sejong (1.99) regions, respectively. The perinatal mortality rates for areas vulnerable and invulnerable to maternal and neonatal healthcare accessibility were 2.97 and 2.92, respectively, but there was no statistically significant difference in this rate (P = 0.789). The maternal mortality ratio for areas vulnerable and invulnerable to maternal and neonatal healthcare accessibility were 14.28 and 9.48, respectively; this ratio was significantly higher in areas vulnerable to accessibility (P = 0.022). @*Conclusion@#Of the PMCSAs across the country, 25.6% (10/39) were deemed to be vulnerable to MFICU and NICU accessibility. There was no difference in the perinatal mortality rate between the vulnerable and invulnerable areas, but the maternal mortality ratio in vulnerable areas was significantly higher than that in invulnerable areas.