The allocation of medical resources refers to how governments or markets fairly and effectively distribute medical resources to different regions, departments, fields, projects, and populations, in order to maximize the social effects and economic benefits of medical resources. The fairness of medical care is closely related to every member of society in any country and is a crucial factor for social stability. Among medical resources, the emergency medicine department is a vital part, often seen as the "guardian" of life in hospitals, with the most critical patients, numerous departments, and significant structural and management tasks.
In Seoul, due to various factors, emergency medical resources cannot be evenly distributed spatially. Inevitably, some areas may have abundant medical resources while others may lack them, potentially exacerbating urban inequality. Therefore, it is necessary to understand the distribution of emergency medical resources in Seoul and promote a more rational allocation of these resources.
When Hansen (1959) first introduced the concept of "accessibility," he defined it as the opportunity for interaction among nodes in a transportation network. In human geography, accessibility is generally understood as the ease of reaching from one point to another. Overall, most studies on accessibility emphasize the convenience of locations, distances, and transport from a spatial perspective (Shen Yue, 2020).
Accessibility of medical resources is understood as the ease with which residents can obtain medical resources. Understanding medical resources, identifying areas with a shortage of medical resources, and optimizing the spatial distribution of medical resources are of great significance. Currently, the most commonly used methods for measuring accessibility of medical resources in research are the 2SFCA and gravity potential model method. This study primarily employs the 2SFCA method.
Luo et al. (2004) used the original floating catchment area method to analyze areas lacking medical resources in Illinois, USA. However, this method assumes that medical resources within a region are equally accessible to all residents of that region, which is a limitation. To overcome this deficiency, Radke et al. (2000) proposed the 2SFCA method. It revolves around demand and supply points, seeking supply or demand points within a threshold range, reflecting resource allocation through a supply-demand ratio. This algorithm is easy to understand and apply, and due to its excellent practicality, it has attracted widespread attention and application and has developed various extended forms.
In China, many scholars have also used 2SFCA for empirical studies on the accessibility of medical facilities. For example, Liu et al. (2007) used this method to analyze the accessibility of medical spaces in Beijing. They considered the interactions between patients and hospitals across administrative divisions and proposed the spatial structure of medical services in Beijing and the accessibility differences of medical service spaces under different search radii. Meng et al. (2017) applied the 2SFCA model based on different modes of transportation to assess the medical accessibility of residents in Beijing. Yang et al. (2020) improved the 2SFCA model by introducing a power function distance decay function and assessed the spatial accessibility of medical facilities in the central area of Shanghai.
Most of the above studies have researched hospitals as a whole concept and have not conducted specialized studies on more specific medical facilities. This research will focus on the emergency room facilities within medical resources. According to the Korea Disease Control and Prevention Agency (KDCA) data from March 2023, the median time for severely injured patients to reach the emergency room from a 119 call increased by 7 minutes, from 25 minutes in 2015 to 32 minutes in 2020. Patients requiring urgent surgery are facing increasingly severe emergency medical dilemmas. Therefore, this study will focus on emergency room facilities, analyzing the current accessibility of emergency room facility resources in various administrative dongs of Seoul, identifying weak areas in emergency medical resources, and providing evidence to improve the emergency medical system.
3.1 Research Data
The geographical location data of emergency rooms in Seoul used in this study was obtained from the Korean Public Data Portal (공공데이터포털), with the data as of June 2021. The population data for each administrative neighborhood were acquired from the Korean National Statistical Office website (KOSIS), with statistics as of the year 2020.
Looking at the data on the location of emergency rooms, as of 2021, there were a total of 63 emergency rooms in Seoul. The Yeongdeungpo District had the highest number of emergency rooms, totaling 9, while other districts had between 1 to 4, indicating a relatively even geographical distribution of emergency rooms (Figure 1).
<Figure 1> Spatial Distribution of Emergency Rooms in Seoul
Regarding the size of the emergency rooms, among the 63 emergency rooms, 54 are located within general hospitals, and 9 within ordinary hospitals. The distinction lies in the different quantities of medical resources they can offer. According to Korean medical law, medical facilities that can accommodate more than 30 patients are classified as ordinary hospitals, while those that can accommodate more than 100 patients are classified as general hospitals.
3.2 Introduction to the 2SFCA Method
This method is developed based on improvements to the earlier moving search method and essentially represents an evolution of the potential model. This approach initially sets a threshold (either in terms of moving time or distance), and only considers supply points or demand points (residential points) within this threshold, disregarding factors beyond it. The accessibility analysis is divided into two steps.