Health Policy Manag.  2023 Sep;33(3):253-263. 10.4332/KJHPA.2023.33.3.253.

Relationship between the Level of Local Extinction and Total Medical Service Uses

• Park JH
• Oh JH
• Kang JG
• Jeong YJ
• Lee KS

• KMID: 2549112
• DOI: http://doi.org/10.4332/KJHPA.2023.33.3.253

Abstract

Background
The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization.
Methods
A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data.
Results
Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day.
Conclusion
This study showed that the higher the region’s extinction risks, the higher the region’s total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

Keyword

Local extinction index; Inpatient day; Visits; Medical charges