Regional Disparities and Need-Based Equity in Hospice and Palliative Care Resource Distribution in South Korea

ObjectiveTo evaluate regional disparities and need-based equity in the distribution of hospice and palliative care resources in South Korea between 2008 and 2024.MethodsA longitudinal analysis using national data was conducted. Regional disparities in the distribution of inpatient hospice units and beds per 1000 cancer deaths were assessed using the Gini coefficient and Lorenz curve. Need-based equity was assessed using the concentration curve and index, with regions ranked by age-standardised cancer mortality. The regional distribution of hospice units was also compared across hospice types in 2024.ResultsThe Gini coefficient for inpatient hospice units decreased from .39 in 2008 to .19 in 2024, indicating a substantial reduction in regional disparities, whereas that for inpatient hospice beds changed little, from .27 to .28. The concentration index changed from .07 to -.09 for inpatient hospice units and from .20 to -.14 for inpatient hospice beds, indicating a shift towards a relative concentration of resources in regions with greater healthcare need. In 2024, regional disparities were greatest for consultative hospice units, followed by home-based and inpatient hospice units.ConclusionsRegional disparities in the distribution of inpatient hospice units decreased between 2008 and 2024, whereas disparities in inpatient hospice bed distribution changed little. The distribution of both inpatient hospice units and beds shifted towards regions with greater healthcare need.