Background Primary care physicians perform a comprehensive role by providing continuous, patient-centered, and accessible healthcare and establishing connections with specialized care. However, the association between the supply of primary care physicians and mortality rates in South Korea has not been thoroughly investigated.
Methods This study utilized data from 229 si-gun-gu in South Korea from 2016 to 2020. The densities of primary care physicians, physicians in functional primary clinics, specialists in primary care facilities, and active physicians per 100,000 people were independent variables. Age-adjusted all-cause mortality and cause-specific mortality rates per 100,000 individuals were the dependent variables. Negative binomial regression, negative binomial regression with a pseudo-panel approach, and geographically weighted regression were used to analyze the data.
Results Our study revealed a significant negative association between the density of primary care physicians and all-cause mortality. An increase in a primary care physician per 100,000 population was significantly linked to a 0.11% reduction in all-cause mortality (incidence rate ratio, 0.9989; 95% confidence interval, 0.9983–0.9995). Similar associations have been observed between mortality rates owing to cardiovascular diseases, respiratory tract diseases, and traffic accidents.
Conclusion This study provides evidence that having a higher number of primary care physicians in South Korea is associated with lower mortality rates. Future research should consider better indicators that reflect the quality of primary care to better understand its impact on population health outcomes. These findings emphasize the significance of strengthening primary care in the South Korean healthcare system to improve the overall health and wellbeing.
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Income-Based Inequalities in Health System Performance in the US and South Korea Sungchul Park, Karen Eggleston, Young Kyung Do, David M. Cutler JAMA Health Forum.2026; 7(3): e260136. CrossRef
Transition to a Primary Care–Centered Healthcare System: A Structural Reform for Korean Healthcare Serng Bai Pak, Sang-Hyun Lee, Kyung-Hee Cho, Juhwan Oh, Sang-il Lee, Kunhee Park, Jae-Heon Kang, Seung-Won Oh, Hee Gyung Kang, Mihwa Yoo Korean Journal of Family Practice.2026; 16(1): 33. CrossRef
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Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024 Seung-Won Oh Korean Journal of Family Medicine.2025; 46(2): 55. CrossRef
Current Status and Future Directions of Primary Care in the World: Insights from Japan Sinyoung Cho, Belong Cho, Seo Eun Hwang Korean Journal of Family Practice.2025; 15(1): 22. CrossRef
Impact of general practitioners and specialists on mortality: a longitudinal study Akin Dayan, Erdinc Unal, Egemen Tural BMC Health Services Research.2025;[Epub] CrossRef
Assessing the impact of physician supply inequality on mortality in China: implications for global health Maomao Cao, Wei Jiang, Run Dong, Yan Chen, Rong Liufu, Li Weng, Bin Du International Journal for Equity in Health.2025;[Epub] CrossRef
Spatial patterns and socio-environmental determinants of gonorrhea incidence in China Ke Hu, Xingjin Yang, Yu Cai, Chaojie Li, Xing Zhang, Di Xiao, Mingyang Yu Frontiers in Public Health.2025;[Epub] CrossRef
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Background : CRC is an ideal target for population screening because it is a prevalent disease with an identifiable precursor lesion. This study was performed for the purpose of comparing cost-effectiveness of CRC screening strategies.
Methods : The natural history of a simulated cohort of 50- year-old Koreans in the general population was modeled with and without CRC screening until age 80 years. We evaluated 16 different screening strategies with Markov model. Cases of positive screening test results were worked up with a colonoscopy. After polypectomy, colonoscopy was repeated every 3 years. Our main outcome measurements were discounted lifetime costs, life expectancy and incremental cost-effectiveness (CE) ratio, comparing 16 different CRC screening strategies.
Results : In base-case analysis, compliance was assumed to be 60% with the initial screen and 80% with follow-up or surveillance colonoscopy. The non-dominated strategies were colonoscopy every 10 years (COL10), colonoscopy every 5 years (COL5) and colonoscopy every 3 years (COL3). Strategies that only included sigmoidoscopy were generally not regarded as non-dominated strategies, but sigmoidoscopy every 5 years (SIG5) showed similar cost and effects as COL10 while sigmoidoscopy every 3 years (SIG3) had similar results as COL5. Other strategies recommended by the expert panel, such as sigmoidocopy plus colon study every 5 years were less cost-effective than the alternatives.
Conclusion : Colonoscopy is the most cost-effective strategy in Korea for colorectal cancer screening. Unfortunately, the number of physicians skilled enough to perform colonoscopy is not enough to meet the demands of screening for colorectal cancer in average-risk adults. Therefore, we consider alternative strategies such as SIG5 or SIG3.
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