Health Policy and Systems
Jaehong Yoon, PhD
Research Professor
National Traffic injury Rehabilitation Hospital
Yangpyeong-gun, Kyonggi-do, Republic of Korea
Yoonjeong Choi, PhD
Research professor
National Traffic Injury Rehabilitation Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Miji Kim, BS
Researcher
National Traffic injury Rehabilitation Hospital
Jongno-gu, Seoul-t'ukpyolsi, Republic of Korea
Jun Hee Won, MD
Clinical fellow
National Traffic injury Rehabilitation Hospital
Yangpyeong-gun, Kyonggi-do, Republic of Korea
Yun Hwa Jung, PhD
Research Professor
National Traffic Injury Rehabilitation Research Institute
Yangpyeong, Kyonggi-do, Republic of Korea
Ja-ho Leigh, PhD
Professor
National Traffic Injury Rehabilitation Research Institute
Yangpyeong, Kyonggi-do, Republic of Korea
Rehabilitation improves functional recovery in severe trauma patients. However, rehabilitation services in South Korea have historically concentrated on central nervous system disorders. This study aimed to examine the spatial relationship between severe trauma incidence and the utilization of rehabilitation physiotherapy across all 247 administrative districts in 2023 in South Korea.
Design:
This cross-sectional ecological study was conducted using the 2023 National Health Insurance Service claims database. Severe trauma was defined as ICD-10 S or T codes with Emergency Medical Record-Injury Severity Score ≥25. Incidence per 100,000 people was calculated for 247 administrative districts. Rehabilitation utilization for administrative district was measured as the volume of specialist physiotherapy claims based on the residential areas of patients. Global correlation was assessed using Spearman’s rank correlation in STATA/MP, and local spatial correlation was examined with the Local Bivariate Relationship tool in ArcGIS Pro 3.5.
Results:
The mean incidence of severe trauma was 219.1 per 100,000 people. Global analysis showed a significant negative correlation between incidence and rehabilitation utilization (r = -0.5997, p < 0.001). Local analysis revealed no positive linear associations; 50 districts (20.24%) showed negative linear relationships (p-value < 0.05), and 6 districts (2.43%) showed convex patterns (p-value < 0.05).
Conclusion:
Regions with higher severe trauma incidence exhibited lower utilization of specialist rehabilitation services. This inverse relationship was statistically significant both globally and in specific local clusters. High incidence rates of severe trauma were concentrated in rural, mountainous and coastal rather than capital and metropolitan areas. These findings imply geographic disparities in rehabilitation utilization and suggest the need for resource reallocation to support the recovery and social reintegration of severe trauma patients in underserved regions
