|
KMID : 1170320200260040023
|
|
Korean Journal of Health Economics and Policy
2020 Volume.26 No. 4 p.23 ~ p.45
|
|
|
Factors Affecting the Migration of Dialysis Patients between Medical Service Regions
|
|
Kim Min-Kyoung
Kwon Soon-Kil
Choi Woong
Tak Yang-Ju
Park Jong-Hyock
Kang Gil-Won
|
|
|
Abstract
|
|
|
|
This study attempts to fill this gap by analyzing the migration of dialysis patients between medical service regions and the underlying factors influencing the migration, thereby providing a reference data for future medical services management policy of dialysis patients. The database for the analysis was established by using the qualification and insurance claim data of health insurance recipients, medical institution data, Korean Society of Nephrology data and national statistical office data, from 2003 to 2015. The effect of the Migration of Dialysis Patients between Medical Service Regions on individual, medical institutions and community characteristics were analyzed by multilevel logistic regression analysis. There is greater inconsistency between the residential and medical service regions for dialysis patients who are male, under 29 years old, belong in the 9th-10th income quintile, and are performing peritoneal dialysis, while there is greater consistency if the co-morbidity index is lower and periods of staying in or visiting hospitals are shorter. In terms of medical institution factors, greater inconsistency is exhibited if patients use care hospitals, and greater consistency with lower number of beds. For the local social factors, consistency increases with a higher number of dialyzers and higher financial independence, a greater ratio of aging population and population density. To conclude, political support is required to resolve the imbalance in medical services by reorganizing the medical service boundaries and enhancing the geographical proximity and resource distribution to patients around medium-sized medical service regions rather than large ones.
|
|
|
KEYWORD
|
|
|
Hemodialysis, Peritoneal dialysis, medical service region, Multilevel logistic regression analysis
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|