Journal of Preventive Medicine and Public Health

Original Article

Assessing Hospital Surgical Functions in Korea: A Functional Analysis Using the Disease Control Priorities, 3rd Edition Essential Surgery List (2013-2022): Haibin Bai, Jin-Hwan Kim, Yukyung Park; J Prev Med Public Health. 2025;58(6):635-646. Published online September 23, 2025; DOI: https://doi.org/10.3961/jpmph.25.407

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Abstract Summary PDF Supplementary Material: Objectives
Korea has achieved near-universal health coverage through a predominantly privatized healthcare system. However, this structural fragmentation has created significant ambiguity regarding the roles of different healthcare organizations, particularly in ensuring equitable provision of essential surgical services across geographic and institutional boundaries.
Methods
We conducted a retrospective study using the full national health insurance claims database provided by the Health Insurance Review & Assessment Service (2013-2022). Essential surgical procedures from the Disease Control Priorities, 3rd edition Essential Surgery List were mapped to insurance claims codes, and their provision was analyzed across healthcare facilities and regions. Functional capacity was defined using minimum annual volume thresholds of 12, 24, 60, and 120 procedures.
Results
Essential surgery more than doubled between 2013 and 2022, increasing from 2.79 million to nearly 6 million cases. Superior general hospitals and general hospitals consistently delivered high volumes of essential surgeries, while hospital-level facilities experienced marked functional decline, particularly in obstetric services. We observed increasing centralization of surgical services in higher-tier and metropolitan facilities, alongside selective decentralization for lower-risk procedures such as cataract surgery. Regional disparities were especially pronounced for obstetric care.
Conclusions
Functional capacity for essential surgery remains highly uneven across hospitals and regions, undermining equitable access. Policy efforts should focus on strengthening lower-tier hospitals in underserved areas and implementing minimum functionality standards tailored to local needs. Clarifying institutional roles within Korea’s mixed healthcare system is essential to improving accountability and ensuring equitable distribution of essential surgical services.; Summary

Korean summary
본 연구는 DCP3 Essential Surgery List를 한국의 건강보험 청구자료(2013–2022)에 적용하여 필수수술 제공기관의 기능적 변화를 평가하였다. 전체 필수수술 건수는 크게 증가했음에도 불구하고 이를 제공하는 의료기관 수는 지속적으로 감소하며 지역 간 격차도 확대되고 있었다. 필수수술 접근성을 강화하기 위해서는 우선 의료기관 수준별로 제공해야 할 필수 기능을 명확히 규정하는 정책적 가이드가 필요하며, 이를 기반으로 지역 단위의 종합병원·병원급 기능을 지속적으로 모니터링하고 관리하는 체계를 마련해야 한다.

Key Message
This study applies the DCP3 Essential Surgery List to South Korea’s national health insurance claims data (2013–2022) and shows that, despite a substantial rise in essential surgery volumes, the number of institutions providing these procedures has declined, widening regional disparities. Strengthening access to essential surgery requires first establishing clear guidance on the functions expected at each level of care, followed by systematic monitoring to ensure that general and hospital-level facilities maintain the capacity to deliver these core services. Such a combined approach is critical for securing equitable and regionally sustained surgical access.

COVID-19: Special Article

Mainstreaming of Health Equity in Infectious Disease Control Policy During the COVID-19 Pandemic Era: Hongjo Choi, Seong-Yi Kim, Jung-Woo Kim, Yukyung Park, Myoung-Hee Kim; J Prev Med Public Health. 2021;54(1):1-7. Published online January 15, 2021; DOI: https://doi.org/10.3961/jpmph.20.593

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12 Crossref

The Korean government’s strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.

Summary

Korean summary
"이 연구는 코로나19 대유행이 건강불평등에 미치는 영향을 검토하고, 불평등 완화 방안을 제시하고자 한다. 건강의 사회적 결정요인은 코로나19와 건강불평등을 이해하기 위한 출발점이다. 건강의 사회적 결정요인은 코로나19 감염과 그로 인한 사망 등 직접영향 경로와 코로나19 대응과정의 문제로 건강불평등을 야기하는 간접영향 경로에 모두 관여한다. 공중보건위기로 인한 건강불평등을 줄이기 위해서는 시민참여를 통한 협력적 거버넌스 강화와 모든 건강정책에서 사람중심돌봄의 관점을 견지하는 것이 필요하다."

Citations

Citations to this article as recorded by

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International Journal of Disaster Risk Reduction.2026; 132: 105954. CrossRef
Experience of Medical Personnel Dispatched to Isolated Psychiatric Institution in Korea During COVID-19: Content Analysis
Youngjoo Kim, Jung Hee Hyun, Jacob Lee, Yoonyoung Nam, Eunshil Yim, Kyounga Lee, Baegju Na
Journal of Preventive Medicine and Public Health.2025; 58(4): 431. CrossRef
The Predestined Failure of the Market Mechanism in Ensuring Health for all in Times of a Pandemic: The Case of the Republic of Korea
Jin-Hwan Kim
International Journal of Social Determinants of Health and Health Services.2025; 55(4): 465. CrossRef
How have researchers defined institutions, politics, organizations and governance in research related to epidemic and pandemic response? A scoping review to map current concepts
Austin Wu, Shivangi Khanna, Shelly Keidar, Peter Berman, Laura Jane Brubacher
Health Policy and Planning.2023; 38(3): 377. CrossRef
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BMC Public Health.2023;[Epub] CrossRef
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Ambient PM_2.5 exposures could increase risk of tuberculosis recurrence
Kyung-Duk Min, Sun-Young Kim, Sung-il Cho
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Unequal burdens of COVID-19 infection: a nationwide cohort study of COVID-19-related health inequalities in Korea
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Disaster Vulnerability and Community Resilience Factors Affecting Post-Disaster Wellness
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Original Articles

Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis: Yukyung Park, Chang-yup Kim, Myoung Soon You, Kun Sei Lee, Eunyoung Park; J Prev Med Public Health. 2014;47(6):298-308. Published online November 11, 2014; DOI: https://doi.org/10.3961/jpmph.14.029

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Abstract PDF: Objectives
To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs.
Methods
We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts (‘gu’s) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer.
Results
The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively.
Conclusions
Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.; Summary

Association Between Local Government Social Expenditures and Mortality Levels in Korea: Hansoo Ko, Jinseob Kim, Donggil Kim, Saerom Kim, Yukyung Park, Chang-yup Kim; J Prev Med Public Health. 2013;46(1):1-9. Published online January 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.1.1

11,175 View
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3 Crossref

Abstract PDF

Objectives

We examined the association between social expenditures of the local government and the mortality level in Korea, 2004 to 2010.

Methods

We used social expenditure data of 230 local governments during 2004 to 2010 from the Social Expenditure Database prepared by the Korean Institute for Health and Social Affairs. Fixed effect panel data regression analysis was adopted to look for associations between social expenditures and age-standardized mortality and the premature death index.

Results

Social expenditures of local governments per capita was not significantly associated with standardized mortality but was associated with the premature death index (decline of 1.0 [for males] and 0.5 [for females] for each expenditure of 100 000 Korean won, i.e., approximately 100 US dollar). As an index of the voluntary effort of local governments, the self-managed project ratio was associated with a decline in the standardized mortality in females (decline of 0.4 for each increase of 1%). The share of health care was not significant.

Conclusions

There were associations between social expenditures of the local government and the mortality level in Korea. In particular, social expenditures per capita were significantly associated with a decline in premature death. However, the voluntary efforts of local governments were not significantly related to the decline in premature death.

Summary

Citations

Citations to this article as recorded by

Association of Health and Social Spending With Health Outcomes in OECD Countries
Sungchul Park, Joseph L. Dieleman, Rockli Kim, S. V. Subramanian
Health Services Research.2025;[Epub] CrossRef
Public health management: systemic analysis of social determinants of health in Brazilian municipalities
Francisco Carlos Carvalho de Melo, Rodolfo Ferreira Ribeiro da Costa, Jansen Maia Del Corso
Health Policy and Planning.2020; 35(2): 123. CrossRef
The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey
Hye Ah Lee, Hyejin Han, Seonhwa Lee, Bomi Park, Bo Hyun Park, Won Kyung Lee, Ju Ok Park, Sungok Hong, Young Taek Kim, Hyesook Park
BMC Public Health.2018;[Epub] CrossRef

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