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Original article The Effect of Public Hospital Closure on the Death of Long-term Inpatients
Taeuk Kang1orcid , Minsung Sohn2orcid , Changwoo Shon3orcid
Epidemiol Health 2024;e2024022
DOI: https://doi.org/10.4178/epih.e2024022 [Accepted]
Published online: January 17, 2024
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1Health and Wellness College, Sungshin Women’s University Woonjung Green Campus, Seoul, Republic of Korea
2Division of Health Care Science, The Cyber University of Korea, Seoul, Republic of Korea
3Graduate School of Public Health, Inje University, Busan, Republic of Korea
Corresponding author:  Minsung Sohn,
Email: cwshon21c@gmail.com
Changwoo Shon,
Email: cwshon21c@gmail.com
Received: 18 July 2023   • Revised: 2 January 2024   • Accepted: 4 January 2024

OBJECTIVES
This study aimed to examine the changes in health outcomes and the patterns of medical institution utilization among patients with long-term stays in public hospitals following the closure of a public medical center. It also sought to present a proposal regarding the role of public hospitals in countries with healthcare systems predominantly driven by private entities, such as Korea.
METHODS
To assess the impact of a public healthcare institution closure on health outcomes in a specific region, we utilized nationally representative health insurance claims data. A retrospective cohort study was conducted for this analysis.
RESULTS
An analysis of the medical utilization patterns of patients after the closure of Jinju Medical Center showed that 67.4% of the total medical usage was redirected to long-term care hospitals. This figure is notably high in comparison to the 20% utilization rate of nursing hospitals observed among patients from other medical facilities. These results indicate that former patients of Jinju Medical Center may have experienced limitations in accessing necessary medical services beyond nursing care. After accounting for relevant mortality factors, the analysis showed that the mortality rate in closed public hospitals was 2.67 times higher (95% CI, 0.85-0.96) than in private hospitals.
CONCLUSIONS
The closure of public medical institutions has resulted in unmet healthcare needs, and an observed association was observed with increased mortality rates. It is essential to define the role and objectives of public medical institutions, taking into account the distribution of healthcare resources and the conditions of the population.


Epidemiol Health : Epidemiology and Health