Pediatric care is in shorter supply

When her two-year-old son suddenly developed a high fever, Kim Ju-gyeong, 38, knew what to do: bring him to a big hospital in a city near her home in Yeoju, Gyeonggi.

Knowing the pediatrics departments started at 7 a.m., she arrived an hour earlier. But even at 6 a.m., the hospital was so jammed she knew the child would never see a doctor.

The next day, her husband managed to get an appointment at a neighborhood clinic. He was diagnosed with pneumonia.

“If the pneumonia was serious, we could have been in real trouble,” Kim said.

Korea’s pediatric clinics and hospitals are backed up with patients.

“On Mondays and Saturdays, there are many times where even before the start of work, all appointments are fully booked.”

And Yeoju is considered well served medically, with four pediatric clinics or hospitals for a population of 110,000. The Ministry of Health and Welfare has identified 27 regions across the country as vulnerable areas for pediatric care.

A vulnerable area for pediatric care is a place in which 30 percent of the residents must travel over an hour to get to a medical facility, or where 70 percent of residents have to wait more than an hour for a medical appointment.

Gangwon and North Gyeongsang have the highest number of vulnerable areas for pediatric care with six each. Vulnerable areas are generally in rural regions where the population under the age of 19 is around 5,000 people.

In Inje County, Gangwon, the only pediatric care is at local community health centers or in neighboring Hongcheon County.

An Myeong-gi, head of the community health center in Hapcheon County, South Gyeongsang, said, “We only have around 500 kids. When a country has a low fertility rate and graying society, it is inevitable for the [comparative] weight of pediatrics in hospitals to decrease while elderly care increases.”

The government is providing financial support for vulnerable regions. But its effectiveness is questioned.

Even when they get the support, 318 million won ($278,000) in the first year support and 250 million won in the second, the central government only pays half and local governments must pony up the rest.

With such low birth rates, Korea’s pediatricians have no choice but to relocate to large cities where babies abound or they can’t make a living. Many families choose other medical specialists such as general practitioners and otolaryngologists over pediatricians after their children leave infancy.

“A long discussion is necessary as to how many pediatrics specialists are needed for particular areas where the numbers of kids are diminishing,” Lee Seu-ran, head of the Office of Healthcare Policy at the Health Ministry, said. “Research on the demand for [specific] types of specialists should be started and the treatment categories must be classified by region.”

Some say that hospitals and medical treatment must go beyond market forces to serve their communities.

“The dilemma of vulnerable areas for pediatrics is caused by decreasing demand, so it can never be resolved through the principles of the market,” Lee Sang-yi, professor at the School of Medicine at Jeju National University, said.

BY CHU IN-YOUNG [hwang.hosub@joongang.co.kr]