Mathematical Modeling of Regional Healthcare Accessibility and Excess Mortality during COVID-19: A Cluster-Based Study in South Korea

Abstract Background: Healthcare accessibility is a key determinant of health outcomes during pandemics. Disparities in access may contribute to indirect excess mortality beyond reported COVID-19 deaths. This study quantitatively examines the impact of regional healthcare accessibility on non-COVID excess mortality in South Korea using a mathematical modeling approach. Methods: We first performed hierarchical clustering based on the average travel time to various healthcare facilities, classifying regions into two groups: Cluster 0 (high accessibility) and Cluster 1 (low accessibility). A CatBoost model trained on 2014–2019 data predicted expected deaths for 2020–2022, and excess mortality was calculated as the difference between observed and predicted deaths. Finally, multiple linear regression was then used to evaluate the association between accessibility time and non-COVID excess mortality. Results: Our analysis revealed that regions with high healthcare accessibility (Cluster 0) exhibited excess mortality patterns that closely aligned with reported COVID-19 deaths. In contrast, regions with lower accessibility (Cluster 1) experienced a significant increase in non-COVID excess mortality, particularly during the Omicron surge (fifth and sixth pandemic waves). The regression analysis demonstrated that longer healthcare accessibility times were significantly associated with higher non-COVID excess mortality in later pandemic stages. Conclusion: This study demonstrates that regional disparities in healthcare accessibility contribute to indirect excess mortality during pandemics. The findings highlight the importance of targeted policy interventions, such as strengthening healthcare infrastructure and expanding telemedicine, to reduce health inequalities and enhance public health resilience in future crises.

Mathematical Modeling of Regional Healthcare Accessibility and Excess Mortality during COVID-19: A Cluster-Based Study in South Korea

Monday, July 14 at 6:00pm

Daeil Jang

"Mathematical Modeling of Regional Healthcare Accessibility and Excess Mortality during COVID-19: A Cluster-Based Study in South Korea"

#SMB2025 Follow