title: Imbalance in Cardiovascular Surgery Medical Service Use Between Regions.
abstract: BACKGROUND
  This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions.
  
  
  METHODS
  This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service. We identified developments over the 5-year time period and analyzed the level of regional imbalance regarding cardiovascular surgery through the relative comparison of relevance indexes between cardiovascular and other types of surgery.
  
  
  RESULTS
  The relevance index was high in large cities such as Seoul, Daegu, and Gwangju, but low in regions that were geographically far from the capital area, such as the Gangwon and Jeju areas. Relevance indexes also fell as the years passed. Cardiovascular surgery has a relatively low relevance index compared to key types of surgery of other fields, such as neurosurgery and colorectal surgery.
  
  
  CONCLUSIONS
  This study identified medical service use imbalance between regions for cardiovascular surgery. Results of this study demonstrate the need for political intervention to enhance the accessibility of necessary special treatment, such as cardiovascular surgery.
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Myunghwa
authors.initials: M
authors.lastname: Kim
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Seok-Jun
authors.initials: SJ
authors.lastname: Yoon
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Ji Suk
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Myo Jeong
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine.
authors.forename: Sung Bo
authors.initials: SB
authors.lastname: Sim
authors.affiliation: Department of Preventive Medicine, Konkuk University School of Medicine.
authors.forename: Kun Sei
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine.
authors.forename: Hyun Keun
authors.initials: HK
authors.lastname: Chee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine.
authors.forename: Nam Hee
authors.initials: NH
authors.lastname: Park
authors.affiliation: Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
authors.forename: Choon Seon
authors.initials: CS
authors.lastname: Park
keywords: Cardiovascular surgery; Difference; Medical service use; Relevance index