The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
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Regional difference between the distributions of dental revenues in metropolitan areas and rural areas: Empirical validation of the competition index

대도시와 농어촌에서 치과의료기관 의료수익 분포의 지역 간 차이 : 경쟁 지표에 대한 실증적 검증

  • Received : 2016.08.17
  • Accepted : 2016.10.05
  • Published : 2016.12.01
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Abstract

The increase rate of dentists' competition is very fast at metropolitan areas in South Korea. We compare metropolitan and rural parameters to investigate the relation between competition and revenue variation. The competition and revenue variables of 73 metropolitan and 75 rural areas were calculated from 2010 Census of Service Industry microdata which include non-insurance revenues of dental clinics. Independent sample t-test results showed that the level of competition among dental clinics in metropolitan areas is higher. The lowest and the low ranked revenues are higher in rural areas. The highest and the average revenues are higher in metropolitan areas. But, 25 percentile and median revenues has no significant difference between two areas. Simple log linear regression results showed that the number of clinics could explain the distribution of revenues in both areas better than the density of active dentists and Herfindahl-Hirschman index. In the areas with many clinics have high maximum and average revenues and low minimum revenues. The increasing rate of maximum revenues is higher in metropolitan areas though the decreasing rate of minimum revenues is higher in rural areas. Metropolitan areas have higher Gini coefficients than rural areas, but the increasing rate of Gini coefficients is lower than rural areas. Findings from this study are useful reference when the dentists select the opening areas. One is that the median revenues between metropolitan and rural areas have no significant difference. The other is that the rural areas ensure the more stable and uniform revenues. The results would help to relieve the consumptive competition among dentists and to achieve the distributional efficiency of dental human resources.

Keywords

References

  1. OECD. Health Care Resources, 2016.
  2. 성상철, 손명세. 2014년 건강보험통계연보, 2015;1:1.
  3. 전보영, 최수민, 김창엽. 지역의 경제수준에 따른 의료자원 분포의 형평성 분석, 보건행정학회지 2012;22:85-108.
  4. Cordes SM. The changing rural environment and the relationship between health services and rural development, Health Services Research 1989;23:757.
  5. 박종연, 강명근, 최귀선, 조우현. 농촌지역 병원들 의 경영개선을 위한 전략, 보건행정학회지 2000;10:148-173.
  6. Succi MJ, Lee S-Y, Alexander JA. Effects of market position and competition on rural hospital closures, Health services research 1997;31:679.
  7. 윤진아. 독일의 의료공급 수요계획과 우리나라 의료공급의 지역 간 불균형 문제, 법과 정책연구 2015;15:1265-1291.
  8. Sherman F. The economics of health and health care: Pearson Education India; 2008.
  9. Im GJ, Min HY, Choi JW et al. Financial state of primary care physicians under the Korean insurance system, J Korean Med Assoc 2010;54:98-111.
  10. 임금자, 최진우. 의원 경영실태조사, 대한의사협회 의료정책연구소 연구보고서 2009:1-113.
  11. Leigh JP, Tancredi D, Jerant A, Kravitz RL. Physician wages across specialties: informing the physician reimbursement debate, Arch Intern Med 2010;170:1728-1734.
  12. 신호성, 홍수연. 치과의사 인력 현황 및 수급 예측, 보건사회연구 2007;27:81-102.
  13. 최형길, 김명기. 원저: 분위회귀분석을 이용한 개업 치과의사의 의료수익과 소득에 미치는 요인, 보건행정학회지 2015;25:240-251.
  14. 김준수, 박재용, 한창현. 치과의원의 건강보험 진료비 수입분포와 관련요인, 보건행정학회지 2002;12:84-101.
  15. 임선미, 임금자, 박관준, 박윤형. 일차 진료의원의 진료수입의 형평성 분석연구, 보건행정학회지 2014;24:92-99.
  16. 주종석. 대형병원 쏠림현상 심각, 건강보험심사평가원 보도자료 2011.
  17. St Peter RF, Reed MC, Kemper P, Blumenthal D. Changes in the scope of care provided by primary care physicians, N Engl J Med 1999;341:1980-1985. https://doi.org/10.1056/NEJM199912233412606
  18. Shih YC, Konrad TR. Factors associated with the income distribution of full-time physicians: a quantile regression approach, Health Serv Res 2007;42:1895-1925. https://doi.org/10.1111/j.1475-6773.2006.00690.x
  19. 김유진. 의원간 경쟁이 의사의 진료행태에 미치는 영향-서울지역 의원을 중심으로, 2012;국내석사학위논문.
  20. 박형근. 병원 간 경쟁수준이 병원 재원일수 및 진료비에 미치는 영향(Effects of hospital competition on the average length of stay and cost per inpatient day), 2006;박사학위논문.
  21. 박하영, 권순만, 정영호. 병원시장의 경쟁특성과 병원행태, 보건행정학회지 2008;18:1-20.
  22. 조창익, 임재영, 이수연. 병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향, 한국개발연구 2008;30:129-155.
  23. 사공진, 권의정. 의료기관 간 경쟁이 의료공급자의 진료행태에 미치는 영향에 관한 연구, 보건경제와 정책연구 (구 보건경제연구) 2011;17:1-33.
  24. 최형길, 김명기. 의료기관 간 경쟁과 진료수익 분포를 통해 살펴본 치과의사의 개업 지역 선정, 대한치과의료관리학회지 2015;3:1-20.
  25. Zwanziger J, Melnick GA, Mann JM. Measures of hospital market structure: a review of the alternatives and a proposed approach, Socioeconomic planning sciences 1990;24:81-95. https://doi.org/10.1016/0038-0121(90)90014-X
  26. Joskow PL. The effects of competition and regulation on hospital bed supply and the reservation quality of the hospital, The Bell Journal of Economics 1980:421-447.
  27. Noether M. Competition among hospitals, Journal of Health Economics 1988;7:259-284. https://doi.org/10.1016/0167-6296(88)90028-8
  28. Nguyen NX, Derrick FW. Hospital markets and competition: Implications for antitrust policy, Health care management review 1994;19:34-43.
  29. Lee M-C, Jones AM. Heterogeneity in dentists' activity in Taiwan: an application of quantile regression, Empirical Economics 2006;31:151-164. https://doi.org/10.1007/s00181-005-0028-3
  30. 서수교, 박재용. 의원의 의료보험진료비 수입분포와 그 결정요인, 보건행정학회지 1995;5:1-30.
  31. Hersch P. Competition and the performance of hospital markets, Review of Industrial Organization 1984;1:324-341. https://doi.org/10.1007/BF02354130
  32. 여지영, 정형선. 우리나라 의원에서의 공급자 유인수요 실증분석: 유인수요 효과와 가용성 효과 의 구분, Health policy and management = 보건행정학회지 2015;25:53-62.
  33. 김선미, 문경준, 이광수. 정형외과와 재활의학과 의원의 지역분포 특성 연구, 보건경제와 정책연구 2015;21:43-61.
  34. 통계청. 세계와 한국의 인구현황 및 전망, 2010;2015.
  35. 통계청. 인구 데이터, 2010.
  36. Hart LG, Larson EH, Lishner DM. Rural definitions for health policy and research, American Journal of Public Health 2005;95:1149-1155. https://doi.org/10.2105/AJPH.2004.042432