Despite national initiatives to enhance healthcare accessibility, unmet healthcare needs in South Korea remain notably high, particularly in specific regions. This study investigated the factors contributing to geographical disparities in unmet healthcare needs by employing spatial regression models to examine the spatial interactions between healthcare resources and unmet needs. Utilizing data from the 2020 Community Health Survey and Statistics Korea for 216 local government entities, excluding remote areas to ensure data consistency, we identified significant spatial clusters of unmet healthcare needs. These clusters are primarily located in non-metropolitan regions facing transportation barriers and limited healthcare infrastructure. Spatial regression analysis revealed that general hospitals and clinics are significantly associated with reduced unmet healthcare needs underscoring their critical role in mitigating regional disparities. In contrast, hospitals (≥30 beds) and convalescent hospitals did not exhibit significant effects, likely owing to their focus on specialised inpatient and long-term care services, which do not directly address immediate outpatient needs. These findings advance the understanding of how healthcare resource distribution impacts unmet needs at a regional level in South Korea and highlight the necessity for allocating general hospitals and clinics strategically to promote health equity. Based on these results, we recommend evidence- based policy interventions that optimise existing healthcare resources and strategically deploy new facilities in underserved regions. These insights provide valuable guidance for policymakers to reduce geographical health disparities and enhance overall public health outcomes.

Despite a comprehensive national health insurance system in South Korea, achieving universal healthcare access remains challenging. Unmet healthcare needs

Introduction: Adolescent smoking can lead to various health problems including atherosclerosis and cardiovascular disease, making it more difficult to quit smoking during adulthood. This study aims to evaluate the effect of the ordinance by assessing adolescents’ smoking cessation behaviors and environmental conditions, according to the “Ordinance for the Prevention of Child and Adolescent Smoking and Support for Smoking Cessation”, which was enacted in 2019 in Gwangju City, South Korea, for the first time in the country. Methods: The data for the analysis were obtained from the 2018 and 2021 Korea Youth Risk Behavior Survey. Propensity score matching (PSM) ensured homogeneity between ordinance-adopted and non-adopted areas, followed by a difference-in-differences (DID) analysis to assess changes in adolescent smoking behavior, secondhand smoke exposure, and related advertisements. Results: The difference-in-differences analysis of the homogeneous treatment and control groups in 2018 and 2021 showed statistically significant reductions in the variables “experience of secondhand smoke indoors at school” in the secondhand smoke category, and “exposure to smoking advertisements in convenience stores” in the smoking advertising category. However, there were no statistically significant changes in the other eight variables, such as smoking behavior and smoking cessation advertising. Conclusions: The results of this study suggest that the ordinance enacted in Gwangju Metropolitan City in 2019 created a positive environment for smoking prevention in convenience stores and schools for adolescents. Furthermore, if the ordinance is supplemented with the management of smoking behaviors and smoking cessation advertisements, it is expected to achieve the main purpose of the policy, which is to protect adolescents from smoking.

Purpose: This study quantitatively examined the portrayal of physician assistant (PA) nurses in Korean media by integrating text network analysis with latent Dirichlet allocation (LDA) topic modeling.Methods: A total of 3,564 news articles published by nine major Korean media outlets between 2020 and 2024 were analyzed. Content analysis was conducted using term frequency-inverse document frequency calculations, network centrality analysis, and LDA topic modeling to extract key terms, map discourse structures, and identify latent topics.Results: The analysis identified four primary topics in Korean media discourse: “healthcare workforce expansion policies” (30.4%), “hospital clinical practice and operational management” (23.5%), “institutionalization of the PA nursing role” (17.8%), and “COVID-19 response and public health crisis management” (28.3%). High-centrality keywords included “hospital,” “medical,” “patient,” “physician,” “government,” and “nurse,” indicating that the discourse primarily focused on clinical settings. Topic modeling revealed a major shift from pandemic-centered coverage in 2020 to a focus on healthcare workforce policy and PA nurse institutionalization in 2024, coinciding with the passage of the Nursing Act.Conclusion: This study provides empirical evidence suggesting that the portrayal of PA nurses in Korean media discourse evolved from a peripheral regulatory issue to a central healthcare delivery solution, particularly in the contexts of workforce management, clinical practice, and crisis response. Our findings suggest that PA nurse institutionalization received broader attention when positioned as part of systemic healthcare improvements addressing concrete clinical needs. These results offer valuable insights for policymakers and administrators in framing and implementing workforce policy reforms.

Objectives To analyse patient complaints from an early-stage hospital in South Korea using the Healthcare Complaints Analysis Tool, identify harm patterns across care stages and provide insights for resource allocation and risk management. Design Retrospective analysis of patient complaints (22 March 2022–28 June 2024). Setting A newly established general hospital with approximately 700 beds in the metropolitan area of Gyeonggi-do, South Korea, which was established during the COVID-19 pandemic. Participants A total of 1113 patient complaints comprising 1952 discrete complaint issues were collected, with submissions originating from patients themselves (64%), family members or friends (21%) and individuals with unclear relationships to patients (15%). Primary and secondary outcome measures Primary outcome measures comprised occurrence and severity of patient harm. Secondary outcome measures included distribution of complaints across clinical, management and relationship domains, and identification of healthcare stages with concentrated harm using hotspot analysis and logistic regression. Results Of the complaints, 78% did not result in harm. Among those that did, 52%, 40% and 7% were of low, moderate and high severity, respectively. Hotspot analysis indicated that harm was concentrated during diagnosis (stage 2), ward care (stage 3) and operation/procedure (stage 4) stages, with stage 4 exhibiting the highest Pearson residual value of 9.56. Logistic regression indicated that clinical domain complaints had the strongest association with patient harm (OR=32.25, 95% CI=20.88 to 51.01, p<0.001), while the operation/procedure stage exhibited the highest stage-specific risk (OR=30.62, 95% CI=9.80 to 93.93, p<0.001). Conclusions This study highlighted the critical care stages in which harm was concentrated, emphasising the need for proactive risk management particularly during operations and procedures. The findings provide valuable insights into resource allocation and underscore the importance of patient complaints in improving healthcare quality and safety across healthcare institutions.

Background: Patient complaints are critical indicators for improving healthcare quality and patient safety, offering insights into systemic issues within medical institutions. Newly operational hospitals, owing to operational instability and limited resources, are more prone to frequent complaints, reflecting several service delivery problems. Despite the significance of these complaints, systematic analyses of how they evolve and how each complaint domain influences patient harm in new South Korean hospitals have been scarce. Methods: We analysed 1113 patient complaints collected from March 2022 to June 2024 from a newly operational hospital in South Korea. These complaints were categorized into three major domains: Clinical (Quality, Safety), Management (Environment, Institutional Processes), and Relationship (Listening, Communication, Respect and Patient Rights) using the Healthcare Complaints Analysis Tool. Based on a vector autoregression model, we employed dynamic time warping to examine temporal patterns among the complaints and impulse response function analysis to assess the influence of these factors on patient harm over time. Results: The results identified that in the early stages of hospital operations, Clinical Safety and Patient Harm were closely clustered, indicating a strong association between clinical factors and patient harm. In the mid-term period (September 2022–February 2023), Respect and Patient Rights and Environment became major clusters, indicating a shift towards Management and Relationship issues as primary causes of complaints. In the later term (March 2023–June 2024), Environment became clustered with Listening and Communication, whereas Patient Harm became more independent. Impulse response function analysis showed that Clinical factors had a strong, immediate positive impact (0.91017, P < .01 on Day 1) on patient harm that gradually decreased over the subsequent 10-day period. Management factors exhibited a smaller initial effect (0.00756, P < .05 on Day 1) but demonstrated a gradual, cumulative pattern over time. Relationship factors initially had a minimal impact (0.04551, P < .1 on Day 1) but became more significant in later days (0.06566, P < .01 on Day 3). Conclusion: Clinical safety has an immediate, significant negative impact on patients in new hospitals, requiring prompt attention. As hospitals stabilize, Management and Relationship factors play a significant role in patient safety. Our findings underscore the need for dynamic resource allocation and strategic planning that evolves from focusing on clinical safety to incorporating management improvements and patient-centred communication strategies to enhance patient safety and service quality in new hospitals in South Korea.