Participation in a government program to manage chronic conditions such as high blood pressure and diabetes varies sharply by region, data showed. One in four of South Korea's municipal districts has either no neighborhood clinic enrolled in the program or just one. Analysts say that closing the gap in how many providers patients can choose from, depending on where they live, is the first step toward raising chronic disease management rates, a goal included in the government's policy agenda.
An analysis of regional participation data for the Primary Care Chronic Disease Management Program, obtained on the 1st through the office of Rep. Kim Yoon of the Democratic Party of Korea, a member of the National Assembly's Health and Welfare Committee, found that a cumulative 4,185 clinics had enrolled patients between 2019 and last year. Spread across the country's 225 municipal districts, that works out to an average of 18.6 clinics per district.
The distribution was far from even. Thirty-two districts had no participating clinics at all, and 26 had only one. That means 58 districts, or 25.8% of the total, had one or fewer clinics in the program.
The Ministry of Health and Welfare's Primary Care Chronic Disease Management Program is built around neighborhood clinics that patients with high blood pressure or diabetes already visit, providing them with continuous care for their conditions. Participating clinics enroll patients, draw up individual care plans and offer education, counseling and help managing daily habits. Any clinic meeting certain requirements can join voluntarily, anywhere in the country.
Gaps appeared even in the greater Seoul area, where medical institutions are concentrated. Gwangmyeong in Gyeonggi Province had just one clinic enrolled over the entire period. Dongducheon had two, while Ojeong District in Bucheon and Sangnok District in Ansan each had three. Hanam had eight.
Regional care indicators showed similar disparities. An analysis of Community Health Survey data put the median treatment rate among people diagnosed with diabetes at 93.2%, but the figure was 50.7% in Gwacheon, Gyeonggi Province. Yongsan District in Seoul recorded 65.8% and Jungwon District in Seongnam, Gyeonggi Province, 68.0%, both more than 20 percentage points below the median. At the other end, Okcheon County in North Chungcheong Province and Yeongam County in South Jeolla Province both reached 100%, leaving a gap of 49.3 percentage points between the highest and lowest regions.
"Easing the concentration of patients at large hospitals in the greater Seoul area requires strengthening primary care functions within local communities and establishing a patient-centered support system as a key prerequisite," Kim said. "We need to review the results of the various programs pursued so far to strengthen primary care, and quickly address the problems raised in the field."
