B01

Research Abstracts on Spatial Information Science
CSIS DAYS 2007

Spatial Patterns of a Co-Diagnosis System in Korea: A Case Study of AMC General Hospitaland Other Nationwide Medical Institutions
SooKyung Park
Division of Spatial Information Science, University of Tsukuba
Contact address: <maria1570@gmail.com> Web : <http://giswin.geo.tsukuba.ac.jp>(1) Objective: A co-diagnosis system, which is a kindof health care delivery, has been operated since
1989 and aims at preventing concentration ofpatients in some general hospitals and attaining abalanced development among medical institutions.
Related research achievements of health caredelivery up to the present tended to center aroundthe question of Western cases, and the field of
research on the East, including Korea, is relatively
new. So this paper attempted to examine spatial
characteristics or patterns of health care delivery inKorea through a case of AMC General Hospital anddescribe reasons why health care delivery in Korea
does not correspond with an ideal model.
(2) Data and Methods: To analyze spatial patterns of aco-diagnosis system in the present, the author chosea case of AMC General Hospital that is located inSeoul and has great influence on medical services
on Korea. Data on AMC General Hospital andrelated medical facilities, which are referring theirpatients to AMC General Hospital and are
performing their functions as subordinate medical
facilities of AMC General Hospital, was used as
primary data. The total number of used data is 4,805
and is composed of followings: 72 general hospitals(1.5%), 262 hospitals (5.5%), 4,464 clinics (92.9%)
and seven others (for example, military hospitals)(0.1%). The number of used data forms 10 percent
of all medical institutions in Korea. This article waspresented by three steps: 1) clarifying the tendency
of a co-diagnosis relationship using ArcGIS; 2)
exploring another co-diagnosis relationship ofsubordinate medical institutions with data bycomparing data of 55 general hospitals; and 3)
examining reasons of spatial characteristics onhealth care delivery in Korea through quantitativeand qualitative approaches.

(3) Originality: Even though there are a lot of previous
research achievements to reveal optimal range ofhealth care delivery using models, so far, nodefinitive answer has been given to the question ofreal mechanism. So what the author tried to do inthis paper is to address this approach, and it is anoriginality of this article.
(4) Results:
・ According to previous research, the ideal modelof health care delivery is close to Christaller’scentral place theory, that is, primary medical
institutions (clinics or hospitals) depend on
general hospitals located in the same region andthe basic formation of health care delivery
should follow hierarchy structure. But the case of
Korea is different from previous researchachievements. Basically, the number ofco-diagnosis cases is reflected in distance decay,
but most of the primary medical institutions,especially local clinics and hospitals refer theirpatients to AMC General Hospital without
passing local or near general hospitals.
・ In addition, this tendency is clearer throughprimary medical institutions that are located inperiphery not urban areas. Moreover, local
primary medical institutions have anotherco-diagnosis relationship with general hospitals
located in the Metropolitan area, not local
general hospitals.
・ These results are mainly caused by 1) opinions ofpatients who want to consult a doctor in good
general hospitals, 2) a realistic andwell-articulated marketing strategy of AMC
General Hospital, 3) concentration of good
medical institutions in Seoul, and 4) the increaseof advertising impact.

Fig. 1: Distribution of medical institutions that have a co-diagnosis relationship with AMC General Hospital(left; general hospitals: middle; hospitals: right; clinics)- 19 -