- Healthcare Utilization and Discrepancies by Income Level Among Patients With Newly Diagnosed Type 2 Diabetes in Korea: An Analysis of National Health Insurance Sample Cohort Data
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Eun Jee Park, Nam Ju Ji, Chang Hoon You, Weon Young Lee
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J Prev Med Public Health. 2024;57(5):471-479. Published online August 20, 2024
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DOI: https://doi.org/10.3961/jpmph.24.165
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 Abstract
Summary
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- Objectives
The use of qualitative healthcare services or its discrepancy between different income levels of the type 2 diabetes (T2D) patients has seldom been studied concurrently. The present study is unique that regarding T2D patients of early stages of diagnosis. Aimed to assess the utilization of qualitative healthcare services and influence of income levels on the inequality of care among newly diagnosed patients with T2D.
Methods
A retrospective cohort study of 7590 patients was conducted by the National Health Insurance Service National Sample Cohort 2.0 from 2002 to 2015. Insured employee in 2013 with no history of T2D between 2002 and 2012 were included. The standard of diabetes care includes hemoglobin A1c (HbAlc; 4 times/y), eyes (once/y) and lipid abnormalities (once/y). Multivariate logistic regression analysis was performed to examine the difference between income levels and inequality of care.
Results
From years 1 to 3, rates of appropriate screening fell from 16.9% to 14.1% (HbA1c), 15.8% to 14.5% (eye), and 59.2% to 33.2% (lipid abnormalities). Relative to income class 5 (the highest-income group), HbA1 screening was significantly less common in class 2 (year 2: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.61 to 0.99; year 3: OR, 0.79; 95% CI, 0.69 to 0.91). In year 1, lipid screening was less common in class 1 (OR, 0.84; 95% CI, 0.73 to 0.98) than in class 5, a trend that continued in year 2. Eye screening rates were consistently lower in class 1 than in class 5 (year 1: OR, 0.73; 95% CI, 0.60 to 0.89; year 2: OR, 0.63; 95% CI, 0.50 to 0.78; year 3: OR, 0.81; 95% CI, 0.67 to 0.99).
Conclusions
Newly diagnosed T2D patients have shown low rate of HbA1c and screening for diabetic-related complications and experienced inequality in relation to receiving qualitative diabetes care by income levels.
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Summary
Korean summary
의료서비스 이용의 강도와 질을 측정하는 당뇨 관련 합병증 검진율은 저소득층에서 특히 낮았습니다. 보편적 건강 보장이 있는 국가에서도 신환환자 특히 낮은 경제적 계층의 치료 불균형을 해소 하기 위해서는 재정적 부담은 절감하고, 건강 문해력 증진시키고, 일차의료 기관의 기능을 최적화 하여 책임을 강화하는 것이 필요합니다.
Key Message
Diabetic-related complications screening rates that measure the intensity and quality of medical care service usage were statistically lower in low-income groups. Reducing financial burden, promoting health literacy and optimizing the function of primary care physician and reinforcing the health care provider’s accountability are necessary to address the discrepancy of care for those with low socioeconomic status people in early stage of disease, even in nations with universal health coverage.
- The Determinants of the Use of Opportunistic Screening Programs in Korea.
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Sungwook Kang, Chang Hoon You, Young Dae Kwon
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J Prev Med Public Health. 2009;42(3):177-182.
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DOI: https://doi.org/10.3961/jpmph.2009.42.3.177
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Abstract
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- OBJECTIVES
Both organized and opportunistic screening programs have been widely used in Korea. This paper examined the determinants of the use of opportunistic screening programs in Korea. METHODS: The subjects were a national stratified random sample of 10,254 people aged 45 or older from the first wave of the Korean Longitudinal Study of Ageing in 2006. A logit model was used to examine the determinants of the use of opportunistic screening programs in terms of the demographic and socioeconomic characteristics, the type of health insurance and the health status. RESULTS: Thirteen point seven percent of the individuals received opportunistic screening programs within 2 years from the time the survey was conducted in 2006. The individuals who graduated from college or who had even more education were 3.0 times more likely to use opportunistic screening programs compared with the individuals who were illiterate. The individuals who resided in urban areas and who had religious beliefs were more likely to receive opportunistic screening programs compared with their counterparts. Those who were in the first quartile for the total household assets were 2.6 times more likely to use opportunistic screening programs than those who were in the fourth quartile for the total household assets. Privately insured people were 1.6 times more likely to use opportunistic screening programs than those who were not insured. Finally, the individuals who self-assessed their health status as worst were 2.1 times more likely to use opportunistic screening programs compared individuals who self-assessed their health status as best. CONCLUSIONS: This study suggests that opportunistic screening programs can be an indicator for whether or not an individual is among the advantaged group in terms of their socioeconomic characteristics and type of health insurance.
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Summary
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Citations
Citations to this article as recorded by  - A Multi-level Analysis of Factors Affecting Participation in Health Screenings in Korea: A Focus on Household and Regional Factors
So Yoon Park, Young-jeon Shin
Journal of Preventive Medicine and Public Health.2022; 55(2): 153. CrossRef - Factors Associated with Health Check-up and Cancer Screening Participation among Family Caregivers of Patients with Dementia: A Cross-Sectional Study
Bomgyeol Kim, Yejin Lee, Jin-Won Noh, Tae Hyun Kim
BMC Public Health.2021;[Epub] CrossRef - An Empirical Study of Comprehensive Health Screening Medical Service Quality with Kano Model and PCSI Index
Ae-Jun PARK
Journal of Industrial Distribution & Business.2019; 10(7): 71. CrossRef - Determinants of undergoing thyroid cancer screening in Korean women: a cross-sectional analysis from the K-Stori 2016
Ha Na Cho, Eunji Choi, Da Hea Seo, Boyoung Park, Sohee Park, Juhee Cho, Sue Kim, Yeong-Ran Park, Yumie Rhee, Kui Son Choi
BMJ Open.2019; 9(4): e026366. CrossRef - A Study on Longitudinal Associations between Health Screening and Health Behaviors among Older Adults
Yunkyung Jung
Journal of Health Informatics and Statistics.2018; 43(1): 26. CrossRef - Effectiveness of workers’ general health examination in Korea by health examination period and compliance: retrospective cohort study using nationwide data
Huisu Eom, Jun-Pyo Myong, Eun-A Kim, Bohwa Choi, Soon Woo Park, Young Joong Kang
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef - Participation inequality in the National General Health Examination based on enterprise size
Young Joong Kang, Jong Heun Park, Huisu Eom, Bohwa Choi, Seyoung Lee, Ji-Won Lee, Jun-Pyo Myong
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef - Perception about Age at the Start and End of Periodic Health Examinations: a Survey-based Study on University Hospital in Korea
Sujeong Shin, Yun-Mi Song, Hyeonyoung Ko, Yoon-Ho Choi, Woo Yong Lee, Son Mi Chung, Sunyoung Park, Insub Kim, Jinyoung Shin
Korean Journal of Health Promotion.2017; 17(3): 161. CrossRef - Determinants of the Use and Type of Comprehensive Medical Examination Services
Kwan-Sik Moon, Yang-Kyun Kim, Hye-Jung Chang
The Korean Journal of Health Service Management.2016; 10(2): 83. CrossRef - A Study on the Determinants of Rescreening for Using the Private Health Screening Program
Il-Su Park, Yoo-Mi Kim, Sung-Hong Kang
Journal of Digital Convergence.2015; 13(1): 383. CrossRef - Trends and Factors Affecting Participation Rate in Korean National Health Screening among People with Disabilities
Ji Eun Yun, Borami Lim, Seung Hee Ho
Health Policy and Management.2014; 24(2): 172. CrossRef - Relationship between Social Support, Psychosocial Factors, and Health Behaviors in the Elderly
Yun Ho Roh
Health Policy and Management.2013; 23(2): 162. CrossRef - Factors Affecting Diabetic Screening Behavior of Korean Adults: A Multilevel Analysis
Hyeongsu Kim, Minjung Lee, Haejoon Kim, Kunsei Lee, Sounghoon Chang, Vitna Kim, Jun Pyo Myong, Soyoun Jeon
Asian Nursing Research.2013; 7(2): 67. CrossRef - Equity in health care: current situation in South Korea
Hong-Jun Cho
Journal of the Korean Medical Association.2013; 56(3): 184. CrossRef - Analysis of Utilization Characteristics, Health Behaviors and Health Management Level of Participants in Private Health Examination in a General Hospital
Yoo-Mi Kim, Jong-Ho Park, Won-Joong Kim
Journal of the Korea Academia-Industrial cooperation Society.2013; 14(1): 301. CrossRef - A study of the psychosomatic self-reported symptoms of the dental technology students
Soon-Suk Kwon
Journal of Korean Acedemy of Dental Technology.2013; 35(2): 157. CrossRef - Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea
Beomseok Suh, Dong Wook Shin, So Young Kim, Jae-Hyun Park, Weon Young Chang, Seung Pyung Lim, Chang-Yeol Yim, Be-Long Cho, Eun-Cheol Park, Jong-Hyock Park
BMC Cancer.2012;[Epub] CrossRef - Use Characteristics of Health Examinations Services from Health Insurance Subscribers
Ryoung Choi, Byung-Deog Hwang
The Journal of the Korea Contents Association.2011; 11(2): 331. CrossRef - Demographic and Socioeconomic Determinants of the Use of Periodic Health Examinations: Public vs. Private Sector
Young Dae Kwon, Chang Hoon You, Eun-Hwan Oh, Sungwook Kang
The Tohoku Journal of Experimental Medicine.2009; 219(3): 223. CrossRef
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