Korean rheumatology workforce from 1992 to 2015: current status and future demand
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Rheumatology in Korea has rapidly advanced in the 24 years since the subspecialty board certification program was established in 1992. The objective of this investigation was to analyze the distribution of rheumatology practices in Korea in order to better understand the rheumatology workforce. Methods: Using a membership list from the Korean College of Rheumatology (KCR), we obtained information on practicing rheumatologists. We mapped the ratio of rheumatologists to the general population and to patients with rheumatologic disease using data from Statistics Korea and the 2015 Health Insurance Review & Assessment Service (HIRA). Results: In the 16 administrative districts of Korea in 2015, there were 311 practicing rheumatologists on the list of KCR members. There were 218 members practicing in metropolitan areas and 93 members in the provinces. The mean number of rheumatologists per 100,000 people was 0.60, with 0.33/100,000 in the provinces, but 0.92/100,000 in metropolitan areas, a 2.7-fold difference. The number of rheumatologists per 100,000 patients with chronic rheumatic disease was 17.21 in metropolitan areas but 6.57 in the provinces, according to 2015 HIRA data. This geographic maldistribution emerged as a problem; indeed, the regional disparity in the distribution of Korean rheumatologists was striking when compared to the published medical professional distribution in 2014. Conclusions: Because of the uneven distribution of rheumatologists, it is likely that some patients with chronic rheumatic conditions have limited access to rheumatology care. Thus, a policy-based approach is needed to alleviate this disparity.
Abstract
Background/Aims: Rheumatology in Korea has rapidly advanced in the 24 years since the subspecialty board certification program was established in 1992. The objective of this investigation was to analyze the distribution of rheumatology practices in Korea in order to better understand the rheumatology workforce. Methods: Using a membership list from the Korean College of Rheumatology (KCR), we obtained information on practicing rheumatologists. We mapped the ratio of rheumatologists to the general population and to patients with rheumatologic disease using data from Statistics Korea and the 2015 Health Insurance Review & Assessment Service (HIRA). Results: In the 16 administrative districts of Korea in 2015, there were 311 practicing rheumatologists on the list of KCR members. There were 218 members practicing in metropolitan areas and 93 members in the provinces. The mean number of rheumatologists per 100,000 people was 0.60, with 0.33/100,000 in the provinces, but 0.92/100,000 in metropolitan areas, a 2.7-fold difference. The number of rheumatologists per 100,000 patients with chronic rheumatic disease was 17.21 in metropolitan areas but 6.57 in the provinces, according to 2015 HIRA data. This geographic maldistribution emerged as a problem; indeed, the regional disparity in the distribution of Korean rheumatologists was striking when compared to the published medical professional distribution in 2014. Conclusions: Because of the uneven distribution of rheumatologists, it is likely that some patients with chronic rheumatic conditions have limited access to rheumatology care. Thus, a policy-based approach is needed to alleviate this disparity.
참고문헌 (23)
- Mocsai A, "What is the future of targeted therapy in rheumatology: biologics or small molecules?", BMC Med, 12, pp.43~ (2014)
- Kahlenberg JM, "Advances in the medical treatment of rheumatoid arthritis", Hand Clin, 27, pp.11~20 (2011)
- Kim HY, "The dynamic evolution of rheumatology in Korea", Nat Rev Rheumatol, 12, pp.183~189 (2016)
- Annual Report Membership Statistics Korean Medical Association, "Research Institute for Healthcare Policy", Research Institute for Healthcare Policy, Korean Medical Association, ~ (2015)
- Ito S, "Rheumatology in Japan, Germany, and Egypt : a comparison of medical practices", Acta Med Biol(Niigata), 54, pp.51~58 (2006)
- "OECD Health Statistics 2015" (2015)[URL]
- Zhang FC, "Rheumatology in China : brief introduction of the development of Chinese rheumatology", Rheumatology(Oxford), 45, pp.1323~1324 (2006)
- Brophy J, "Measuring the rheumatology workforce in Canada : a literature review", J Rheumatol, 43, pp.1121~1129 (2016)
- Golle K, "Effect of living area and sports club participation on physical fitness in children : a 4 year longitudinal study", BMC Public Health, 14, pp.499~ (2014)
- "Gastric cancer adequacy assessment result" (2017)[URL]
- 박진현, "제2형 당뇨병 환자의 혈당 비조절 관련 요인분석: 국민건강영양조사(2010-2012) 자료이용", 보건행정학회지, 26(2), pp.125~134 (2016), 한국보건행정학회
- Al Maini M, "The global challenges and opportunities in the practice of rheumatology : white paper by the World Forum on Rheumatic and Musculoskeletal Diseases", Clin Rheumatol, 34, pp.819~829 (2015)
- Hootman JM, "Projections of US prevalence of arthritis and associated activity limitations", Arthritis Rheum, 54, pp.226~229 (2006)
- Hooker RS, "The extension of rheumatology services with physician assistants and nurse practitioners", Best Pract Res Clin Rheumatol, 22, pp.523~533 (2008)
- Henrickson M, "Policy challenges for the pediatric rheumatology workforce. Part II. Health care system delivery and workforce supply", Pediatr Rheumatol Online J, 9, pp.24~ (2011)
- Pincus T, "Urgent care and tight control of rheumatoid arthritis as in diabetes and hypertension : better treatments but a shortage of rheumatologists", Arthritis Rheum, 46, pp.851~854 (2002)
- 정효선, "Thoracic and Cardiovascular Surgeons’ Perception of the Concentration of Cardiovascular Operations in Seoul Metropolitan Area’s Hospitals", Journal of Chest Surgery, 49, pp.53~59 (2016), 대한심장혈관흉부외과학회
- Choi YH, "Analysis of user preferences for regional healthcare services", Korean Assoc Public Adm, 11(Suppl), pp.139~155 (2001)
- Woolf AD, "Burden of major musculoskeletal conditions", Bull World Health Organ, 81, pp.646~656 (2003)
- Desjardins C, "Analysis of the workforce and workplace for rheumatology and the research activities of rheumatologists early in their careers", Arthritis Rheum, 62, pp.3528~3536 (2010)
- American College of Rheumatology Committee on Rheu-matology Training and Workforce Issues, "Regional distribution of adult rheumatologists", Arthritis Rheum, 65, pp.3017~3025 (2013)
- Aneja S, "US cardiologist workforce from 1995 to 2007 : modest growth, lasting geographic maldistribution especially in rural areas", Health Aff(Millwood), 30, pp.2301~2309 (2011)
- 조춘규, "안전한 마취관리를 위한 국내 마취통증의학과 전문의 인력 현황 및 장래 공급량 예측", Anesthesia and Pain Medicine, 11(1), pp.85~90 (2016), 대한마취통증의학회[DOI]