Journal of Preventive Medicine and Public Health

Original Articles

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.

Necessity of Analyzing the Korea Community Health Survey Using 7 Local Government Types: Seowoo Park, Haibin Bai, Jae-ryun Lee, Soomin Kim, Hyemin Jung, Jin Yong Lee; J Prev Med Public Health. 2025;58(1):83-91. Published online November 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.388

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Abstract Summary PDF Supplementary Material: Objectives
This study examined the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size as a more effective tool to address local health problems and deduce practical implications.
Methods
Retrospective survey data from 2023 KCHS were obtained. Frequency analyses were performed for self-rated good health status, current smoking status, and unmet medical needs as proxies for health status, as well as health behavior and healthcare utilization, utilizing individual weights to represent national community residents.
Results
We established a new classification of local governments into 7 types to facilitate regional comparisons. These local government types are presumably composed of populations showing statistically significant differences in demographic characteristics. There were evident differences in health status, health behavior, and healthcare utilization in comparisons of groups categorized by local government types.
Conclusions
This study suggests that regional disparities can be analyzed using a new typology of local governments. This practically effective approach could be used in decision-making for community-centered health projects in terms of community health planning. Future research should conduct analyses of KCHS data that use these 7 local government types to comprehensively reflect regional characteristics.; Summary

Korean summary
이 연구는 지방자치단체 층위와 도·농복합시를 포함한 도시화 정도, 인구 규모를 고려한 분류 기준을 사용하여 지역사회건강조사(KCHS)에 대한 새로운 분석틀의 가능성을 검토한다. 기초 지방자치단체 7가지 유형으로 분류했을 때, 연구 대상자 집단은 인구 통계학적 특성에 대해 유의미하게 달랐으며 건강 상태, 건강 행태 및 의료 이용에 뚜렷한 차이를 보였다. 이 연구는 지역보건의료계획 측면에서 지역사회 중심 건강증진사업에 대한 의사 결정에 실질적으로 효과적인 접근 방법이 될 수 있는 기초 지방자치단체의 새로운 유형을 제안한다.

Key Message
This study examines the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size. In comparisons of groups categorized by 7 local government types, populations were significantly different considering demographic characteristics and there were evident differences in health status, health behavior, and healthcare utilization. This study suggests a new typology of local governments which could be a practically effective approach in decision-making for community-centered health projects in terms of community health planning.

Special Articles

National Cancer Control Plan of the Korea: Current Status and the Fourth Plan (2021-2025): Kyu-Tae Han, Jae Kwan Jun, Jeong-Soo Im; J Prev Med Public Health. 2023;56(3):205-211. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.115

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14 Crossref

Abstract Summary PDF

Cancer management has become a major policy goal for the government of the Korea. As such, the government introduced the National Cancer Control Plan (NCCP) to reduce the individual and social burdens caused by cancer and to promote national health. During the past 25 years, 3 phases of the NCCP have been completed. During this time, the NCCP has changed significantly in all aspects of cancer control from prevention to survival. The targets for cancer control are increasing, and although some blind spots remain, new demands are emerging. The government initiated the fourth NCCP in March 2021, with the vision of “A Healthy Country with No Concerns about Cancer Anywhere at Any Time,” which aims to build and disseminate high-quality cancer data, reduce preventable cancer cases, and reduce gaps in cancer control. Its main strategies include (1) activation of cancer big data, (2) advancement of cancer prevention and screening, (3) improvement in cancer treatment and response, and (4) establishment of a foundation for balanced cancer control. The fourth NCCP has many positive expectations, similar to the last 3 plans; however, cross-domain support and participation are required to achieve positive results in cancer control. Notably, cancer remains the leading cause of death despite decades of management efforts and should continue to be managed carefully from a national perspective.

Summary

Korean summary
- 기존 1~3차 국가암관리계획의 전반적인 성과를 소개합니다. - 제4차 국가암관리계획의 목표 및 내용을 기존 계획과 비교하여 설명합니다.

Citations

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A Strategy Toward Reconstructing the Healthcare System of a Unified Korea: Yo Han Lee, Seok-Jun Yoon, Seok Hyang Kim, Hyun-Woung Shin, Jin Yong Lee, Beomsoo Kim, Young Ae Kim, Jangho Yoon, Young Seok Shin; J Prev Med Public Health. 2013;46(3):134-138. Published online May 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.3.134

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116 Download
3 Crossref

Abstract PDF

This road map aims to establish a stable and integrated healthcare system for the Korean Peninsula by improving health conditions and building a foundation for healthcare in North Korea through a series of effective healthcare programs. With a basic time frame extending from the present in stages towards unification, the roadmap is composed of four successive phases. The first and second phases, each expected to last five years, respectively, focus on disease treatment and nutritional treatment. These phases would thereby safeguard the health of the most vulnerable populations in North Korea, while fulfilling the basic health needs of other groups by modernizing existing medical facilities. Based on the gains of the first two phases, the third phase, for ten years, would prepare for unification of the Koreas by promoting the health of all the North Korean people and improving basic infrastructural elements such as health workforce capacity and medical institutions. The fourth phase, assuming that unification will take place, provides fundamental principles and directions for establishing an integrated healthcare system across the Korean Peninsula. We are hoping to increase the consistency of the program and overcome several existing concerns of the current program with this roadmap.

Summary

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