Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 22;38(20):e147.
doi: 10.3346/jkms.2023.38.e147.

Geographic Distribution of Central Nervous System Rehabilitation Treatment in Korea and Its Associated Factors

Dong-Gyun Sohn #  1   2 , Jaehong Yoon #  3   4 , Jun-Soo Ro  5 , Ja-Ho Leigh  3   4   6
Affiliations

Geographic Distribution of Central Nervous System Rehabilitation Treatment in Korea and Its Associated Factors

Dong-Gyun Sohn et al. J Korean Med Sci. .

Abstract

Background: Health disparity is defined as a difference in the accessibility of medical resources among regions or other factors. In South Korea, there might be a disparity because of the low proportion of public medical institutions. This study aimed to investigate the geographic distribution of rehabilitation treatment and examine the factors associated with the rates of rehabilitation treatment in Korea.

Methods: We used administrative claims data in 2007, 2012, and 2017 from the National Health Insurance Database in Korea. We defined physical therapy and occupational therapy as rehabilitation treatments and analyzed the rate of rehabilitation treatments for administrative districts in 2007, 2012, and 2017. Interdecile range and coefficient of variation were used to investigate the geographic distribution of rehabilitation treatment over time. We applied multiple random intercept negative binomial regression to examine the factors associated with rehabilitation treatment. A total of 28,319,614 inpatient and outpatient claims were submitted for 874 hospitals that provided rehabilitation treatment in 2007, 2012, and 2017.

Results: The increase in the mean rates of physical therapy inpatients and outpatients was greater than those for occupational therapy inpatients and outpatients from 2007 to 2017. Both physical therapy and occupational therapy were concentrated in the Seoul Capital Area and other large urban areas. More than 30% of the districts received no rehabilitation treatment. The interdecile range and coefficient of variation for physical therapy declined more than those for occupational therapy from 2007 to 2017. The deprivation index was negatively correlated with physical therapy inpatients, physical therapy outpatients, occupational therapy inpatients, and occupational therapy outpatients. Furthermore, a 1-unit increase in the number of hospital beds per 1,000 people was associated with 1.42 times higher physical therapy inpatient, 1.44 times higher physical therapy outpatient, 2.14 times higher occupational therapy inpatient, and 3.30 times higher occupational therapy outpatient treatment.

Conclusion: To reduce the geographic inequality in rehabilitation treatment, it is necessary to narrow the gap between the supply and demand of rehabilitation services. Providing incentives or direct provisions from the government might be an alternative.

Keywords: Facilities and Services Utilization; Health Service Accessibility; Healthcare Disparity; Neurological Rehabilitation; Occupational Therapy.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. The trends of mean rate for PT and OT.
PT = physical therapy, OT = occupational therapy.
Fig. 2
Fig. 2. The distribution rate for PT and OT using univariate kernel density estimation.
PT = physical therapy, OT = occupational therapy.
Fig. 3
Fig. 3. Map of PT and OT rates per 100,000 people in Korea from 2007 to 2017.
PT = physical therapy, OT = occupational therapy.
See this image and copyright information in PMC

References

    1. Jørgensen HS, Nakayama H, Raaschou HO, Vive-Larsen J, Støier M, Olsen TS. Outcome and time course of recovery in stroke. Part I: outcome. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995;76(5):399–405. - PubMed
    1. Pappalardo A, D’Amico E, Leone C, Messina S, Chisari C, Rampello L, et al. Inpatient versus outpatient rehabilitation for multiple sclerosis patients: effects on disability and quality of life. Mult Scler Demyelinating Disord. 2016;1(1):3.
    1. Mak MK, Wong-Yu IS, Shen X, Chung CL. Long-term effects of exercise and physical therapy in people with Parkinson disease. Nat Rev Neurol. 2017;13(11):689–703. - PubMed
    1. World Health Organization. Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and Their Measurement Strategies. Geneva, Switzerland: World Health Organization; 2010.
    1. Culyer AJ. Equity - some theory and its policy implications. J Med Ethics. 2001;27(4):275–283. - PMC - PubMed