France‘s APL Model: A Potential Framework for addressing Medical Deserts in Korea
Korea faces increasing challenges in ensuring equitable access to community medical care, particularly in rural adn underserved areas. A promising approach to identifying and addressing these “medical deserts” lies in adapting the French Access aux Professions de santé (APL) model, as highlighted by recent analysis from Medi:Gate News. Unlike customary density-based indicators, the APL offers a more nuanced and thorough assessment of medical accessibility.
The APL calculates regional potential access to community medical care - excluding hospital services - by considering both the supply and demand of healthcare professionals.This calculation isn’t limited by administrative boundaries; it factors in the medical needs of surrounding local governments and accounts for the diminishing accessibility with distance. Crucially, the APL incorporates not just the presence of medical professionals, but also their activity levels and the age structure of the population, wich substantially impacts medical demand. It leverages past observation data to estimate professional activity and uses average medical consumption rates by age group to determine relative local demand.
This complex methodology allows for a more accurate identification of vulnerable areas than simpler metrics. Nationwide, the average APL is 3.3 medical treatments per year.Areas with an APL below 2.5 are classified as low-density, and Korea currently identifies 15.9 such areas – a figure that suggests a potentially greater level of vulnerability compared to France. in France, areas receiving less than two treatments per year are designated “Red Zones” or Zones d’Intervention Prioritaire (ZIPs).
The French system provides meaningful incentives for doctors to practice in these ZIPs,including comprehensive financial support from public health organizations,local governments,and insurance funds. This support can cover expenses like leasing or purchasing property, establishing specialized outpatient clinics, and conducting feasibility studies. This targeted approach, based on the objective APL indicator, is integrated into public health and regional planning policies.
Korea could benefit from benchmarking this system to prioritize areas for initiatives aimed at attracting and retaining local doctors and strengthening local medical care. The APL’s strength lies in its ability to integrate both supply and demand, and to account for patient movement across administrative boundaries. By providing a national standard for defining medical deserts, the APL offers a practical and effective policy tool for improving healthcare access and activating local medical services.
The APL parameters are continually refined, evolving from the initial 2010-2013 version to the current 2025 model, ensuring increasingly sophisticated and reliable data for identifying vulnerable regions.
Reference:
https://drees.solidarites-sante.gouv.fr/communique-de-presse-jeux-de-donnees/jeux-de-donnees/241220_DATA_accessibilite-aux-soins?utm_source=chatgpt.com
[Image of graph from Medi:Gate News article]
Note: this column represents the personal opinion of the columnist and may not reflect the editorial direction of the magazine.
