title: The Longitudinal Trend of Cardiac Surgery in Korea from 2003 to 2013.
abstract: BACKGROUND
  The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery.
  
  
  METHODS
  Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013.
  
  
  RESULTS
  There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high.
  
  
  CONCLUSIONS
  Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.
authors.affiliation: Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine.
authors.forename: Kyeong Soo
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Dental Hygiene, Ulsan College.
authors.forename: Chang Suk
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Big Data Steering Department, National Health Insurance Service.
authors.forename: Jong Heon
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine.
authors.forename: Tae Yoon
authors.initials: TY
authors.lastname: Hwang
authors.affiliation: Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine.
authors.forename: Sang Won
authors.initials: SW
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
keywords: Coronary artery bypass surgery; Health facilities; Heatlh care utilization; Thoracic surgery