Disparity in Health Screening and Health Utilization according to Economic Status.
10.4082/kjfm.2017.38.4.220
- Author:
Min Jung KIM
1
;
Hyejin LEE
;
Eun Ha KIM
;
Mi Hee CHO
;
Dong Wook SHIN
;
Jae Moon YUN
;
Jung Hyun SHIN
Author Information
1. Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea. jie2128@gmail.com
- Publication Type:Original Article
- Keywords:
Economic Status;
Mass Screening;
Health Utilization;
Cardiovascular Diseases
- MeSH:
Cardiovascular Diseases;
Cohort Studies;
Diabetes Mellitus;
Diagnosis;
Dyslipidemias;
Follow-Up Studies;
Humans;
Hypertension;
Infarction;
Mass Screening*;
Mortality;
National Health Programs;
Odds Ratio;
Outpatients;
Renal Insufficiency, Chronic;
Stroke
- From:Korean Journal of Family Medicine
2017;38(4):220-225
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Cardiovascular disease (CVD) has become the most common cause of mortality and morbidity worldwide. Health screening is associated with higher outpatient visits for detection and treatment of CVD-related diseases (diabetes mellitus, hypertension, and dyslipidemia). We examined the association between health screening, health utilization, and economic status. METHODS: A sampled cohort database from the National Health Insurance Corporation was used. We included 306,206 participants, aged over 40 years, without CVD (myocardial infarction, stroke, and cerebral hemorrhage), CVD-related disease, cancer, and chronic renal disease. The follow-up period was from January 1, 2003 through December 31, 2005. RESULTS: Totally, 104,584 participants received at least one health screening in 2003–2004. The odds ratio of the health screening attendance rate for the five economic status categories was 1.27 (95% confidence interval [CI], 1.24 to 1.31), 1.05 (95% CI, 1.02 to 1.08), 1, 1.16 (95% CI, 1.13 to 1.19) and 1.50 (95% CI, 1.46 to 1.53), respectively. For economic status 1, 3, and 5, respectively, the diagnostic rate after health screening was as follows: diabetes mellitus: 5.94%, 5.36%, and 3.77%; hypertension: 32.75%, 30.16%, and 25.23%; and dyslipidemia: 13.43%, 12.69%, and 12.20%. The outpatient visit rate for attendees diagnosed with CVD-related disease was as follows for economic status 1, 3, and 5, respectively: diabetes mellitus: 37.69%, 37.30%, and 43.70%; hypertension: 34.44%, 30.09%, and 32.31%; and dyslipidemia: 18.83%, 20.35%, and 23.48%. CONCLUSION: Thus, higher or lower economic status groups had a higher health screening attendance rate than the middle economic status group. The lower economic status group showed lower outpatient visits after screening, although it had a higher rate of CVD diagnosis.
