후기고령자 대상 지역별 일차의료 인력 자원 분포 분석

초록

Objective : This study examined the regional distribution of primary care personnel for the old-old population in Korea and district-level inequality, analyzing medical doctors (MDs) and Korean medicine doctors (KMDs) separately. Methods : This repeated cross-sectional study used Ministry of the Interior and Safety population data and Health Insurance Review and Assessment Service workforce data. The numbers of MDs and KMDs in clinics and public health centers per 1,000 people aged 75 and older were calculated annually from 2018 to 2025 across 250 districts. Supply and KMD proportion were compared by region type, and inequality was measured with the Gini coefficient and Atkinson index using unweighted district-level rates. Districts at or below the lowest 20% cutoff of combined 2025 supply were defined as undersupplied; a sensitivity analysis excluded public health center personnel. Results : Although absolute numbers increased, the mean district-level supply declined for both MDs (from 10.72 to 10.08) and KMDs(from 4.21 to 3.52) across all region types; in 2025, supply was highest in metropolitan and lowest in rural areas. The Gini coefficient rose for MDs (0.407 to 0.432) but fell for KMDs (0.350 to 0.336), and undersupplied districts increased from 37 to 50. KMD proportion was higher in rural areas (34.4%) and undersupplied districts (37.4%) than the overall district mean(29.4%); this pattern persisted after excluding public health center personnel. Conclusions : Supply relative to the old-old population declined, inter-district inequality in MD supply widened, and KMD proportion was higher in undersupplied districts. KMDs warrant consideration as a primary care resource in these regions.

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