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			Timely access to secondary pediatric services in Korea: a key to reducing child and adolescent mortality							
		
		Minku Kang, Young June Choe, Hye Sook Min, Saerom Kim, Seung-Ah Choe		
			Epidemiol Health. 2024;46:e2024059.   Published online July 5, 2024		
							DOI: https://doi.org/10.4178/epih.e2024059
					
					 
		
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						 Abstract  Summary  PDF
		AbstractOBJECTIVES Geographic disparities in access to secondary pediatric care remain a significant issue in countries with universal health coverage, including Korea. This study investigated the link between geographic access to secondary pediatric care and mortality rates in children and adolescents (0-19 years) in Korea.
 METHODSWe analyzed district-level data to assess the percentage of those aged 0-19 years residing outside of a 60-minute travel radius from the nearest secondary pediatric care provider (accessibility vulnerability index, AVI). RESULTSThe AVI ranged from 0% to 100% across the districts for the study period. The confidence interval (CI) was -0.30 (95% CI, -0.41 to -0.19) in 2017 and -0.41 (95% CI, -0.52 to -0.30) in 2021, indicating that the proportion of those who could not access care within 60 minutes was disproportionately higher in districts with lower socioeconomic status. We found 8% rise in mortality rates among individuals aged 0-19 years for every 10% increase in AVI (95% CI, 1.06 to 1.10). CONCLUSIONSThe study highlights disparities in pediatric care access and their impact on child survival, emphasizing the need for improved access to achieve true universal health coverage.
			Summary 
						Korean summary본 연구는 한국에서 소아 의료 서비스에 대한 지리적 접근성과 아동 사망률 사이의 연관성을 조사하여, 특히 COVID-19 대유행 기간 동안 접근성 제한이 높은 사망률과 관련이 있음을 발견하였다. 이 연구는 아동 및 청소년의 예방 가능한 사망률에 대한 지역 격차를 줄이기 위해 시기적절한 치료 접근성을 개선해야 할 필요성을 강조하였다.
 
			Key MessageThe study investigated the link between geographic access to pediatric services and child mortality in South Korea, finding that limited access, particularly during the COVID-19 pandemic, was associated with higher mortality. The research highlights the need for improved access to timely care to reduce regional disparities in preventable deaths among children and adolescents.
			Citations Citations to this article as recorded by   Global paediatric workforce crisis: lessons from South KoreaYoung June Choe, Kee-Hyoung Lee
 Archives of Disease in Childhood.2025; 110(8): 665.     CrossRef
 
	
		
			Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020							
		
		Jin-Hwan Kim, Saerom Kim, Eunhye Park, Chang-yup Kim		
			Epidemiol Health. 2022;44:e2022081.   Published online September 26, 2022		
							DOI: https://doi.org/10.4178/epih.e2022081
					
					 
		
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						 Abstract  PDF  Supplementary Material
		AbstractOBJECTIVES This study analyzed inequities in excess mortality according to region and socioeconomic position to explain the distribution of excess mortality in Korea in 2020.
 METHODSWe acquired weekly all-cause mortality data from January 2015 to December 2020 from (1) the National Health Insurance Database and (2) Vital Statistics. Excess mortality for 2020 was calculated by comparing the weekly observed and expected deaths from the same period (2015-2019) using quasi-Poisson regression. RESULTSAn inequitable distribution of excess mortality was identified. The estimated excess mortality in Korea was -29,112 (95% confidence interval, -29,832 to -28,391), corresponding to -55 per 100,000, and the ratio of observed deaths to expected deaths was 0.91. Negative excess mortality was observed except for females in the 0-14 age group. Male Medical Aid beneficiaries showed positive excess mortality, while non-disabled and disabled groups showed similar negative values. When the standardized mortality ratio was calculated for the top 10 causes of death, deaths from Alzheimer’s disease and septicemia increased, whereas those from diabetes mellitus and cerebrovascular disease decreased. The decrease in mortality was primarily concentrated in older adults, while the mortality of young females increased due to increased intentional self-harm. CONCLUSIONSThis study adds essential evidence regarding the overall performance of Korea. The observed inequalities according to various socioeconomic variables indicate that the results of strict measures to control coronavirus disease 2019 were not distributed equitably. Efforts should be made to properly evaluate the current and future problems related to the pandemic.
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			Citations Citations to this article as recorded by   Excess mortality during and after the COVID-19 emergency in Japan: a two-stage interrupted time-series designGanan Devanathan, Paul LC Chua, Shuhei Nomura, Chris Fook Sheng Ng, Nasif Hossain, Akifumi Eguchi, Masahiro Hashizume
 BMJ Public Health.2025; 3(1): e002357.     CrossRef
The impact of a medical residents' walkout on mortality rates in South Korea, 2024Jin-Hwan Kim, Saerom Kim
 Health Policy.2025; 159: 105375.     CrossRef
The Power of ‘Publicness’ Discourse: An Analysis of Counter‐Hegemonic Formation Against Health System PrivatisationJiwoo Ha, Chang‐yup Kim
 Sociology of Health & Illness.2025;[Epub]     CrossRef
The political effect of medical dominance in South Korea’s COVID-19 responseSeohwa Park, Jungmin Seo
 Cambridge Review of International Affairs.2025; 38(5): 654.     CrossRef
The Predestined Failure of the Market Mechanism in Ensuring Health for all in Times of a Pandemic: The Case of the Republic of KoreaJin-Hwan Kim
 International Journal of Social Determinants of Health and Health Services.2025; 55(4): 465.     CrossRef
Universal health coverage saves more lives among severely ill COVID-19 patients: A difference-in-differences analysis of individual patient data in South KoreaDaseul Moon, Jeangeun Jeon, Jieun Park, Min-Hyeok Choi, Myoung-Hee Kim, Hongjo Choi
 Health Research Policy and Systems.2024;[Epub]     CrossRef
Excess Deaths in Korea During the COVID-19 Pandemic: 2020-2022So-Jin Im, Ji-Yeon Shin, Duk-Hee Lee
 Journal of Preventive Medicine and Public Health.2024; 57(5): 480.     CrossRef
Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?Rora Oh, Myoung-Hee Kim, Juyeon Lee, Rangkyoung Ha, Jungwook Kim
 Epidemiology and Health.2023; 45: e2023072.     CrossRef
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