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Original Articles
Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach
Vadivelan Kanniappan, Abishek Jayapal Rajeswari, Pearlyn Esther Padma Lawrence, Subash Sundar
J Prev Med Public Health. 2024;57(2):157-166.   Published online January 21, 2024
DOI: https://doi.org/10.3961/jpmph.23.426
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  • 180 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics.
Methods
For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis.
Results
A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients’ parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists.
Conclusions
Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.
Summary
Key Message
The paper investigates the views of pediatricians in Chennai, Tamil Nadu, India, about pediatric physiotherapy. It finds themes including the value of a multidisciplinary approach, the function of experienced physiotherapists, and parental access restrictions via qualitative interviews with ten doctors. To maximize patient outcomes, recommendations include raising awareness, strengthening multidisciplinary cooperation, and creating centralized pediatric rehabilitation centers.
The Impact of Public Transfer Income on Catastrophic Health Expenditures for Households With Disabilities in Korea
Eun Jee Chang, Sanggu Kang, Yeri Jeong, Sungchan Kang, Su Jin Kang
J Prev Med Public Health. 2023;56(1):67-76.   Published online January 16, 2023
DOI: https://doi.org/10.3961/jpmph.22.183
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  • 98 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities.
Methods
We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types.
Results
As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p<0.001). In particular, PTI effectively reduced the likelihood of CHE for low-income households (OR, 0.85; 95% CI, 0.81 to 0.89; p<0.001) and those who received medical benefits (OR, 0.78; 95% CI, 0.68 to 0.89; p<0.001).
Conclusions
This study highlights the positive effect of PTI on decreasing CHE. Household income and the health insurance type were significant effect modifiers, but economic barriers seemed to persist among low-income households with non-Medical Aid beneficiaries. Federal policies or programs should consider increasing the total amount of PTI targeting low-income households with disabilities that are not covered by the Medical Aid program.
Summary
Korean summary
장애인은 비장애인에 비해 소득수준이 낮고 빈곤율이 높으며, 저소득 장애인 가구일수록 소득원천 비중에서 공적이전소득 의존성이 높다. 본 연구는 공적이전소득이 장애인 가구의 재난적 의료비 발생 확률(Odds ratio)을 효과적으로 낮춘다는 점을 밝혔으며, 특히 저소득층 및 의료급여 수급 가구에서 의료비 부담 완화 효과가 큰 것을 확인하였다. 향후 의료급여 적용대상에서 제외되어 건강보험에 가입해 있는 저소득 장애인 가구를 대상으로 추가적인 맞춤형 지원 정책이 필요하다.

Citations

Citations to this article as recorded by  
  • Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019
    Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
    Journal of Preventive Medicine and Public Health.2024; 57(1): 65.     CrossRef
A New Disability-related Health Care Needs Assessment Tool for Persons With Brain Disorders
Yoon Kim, Sang June Eun, Wan Ho Kim, Bum-Suk Lee, Ja-Ho Leigh, Jung-Eun Kim, Jin Yong Lee
J Prev Med Public Health. 2013;46(5):282-290.   Published online September 30, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.5.282
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AbstractAbstract PDF
Objectives

This study aimed to develop a health needs assessment (HNA) tool for persons with brain disorders and to assess the unmet needs of persons with brain disorders using the developed tool.

Methods

The authors used consensus methods to develop a HNA tool. Using a randomized stratified systematic sampling method adjusted for sex, age, and districts, 57 registered persons (27 severe and 30 mild cases) with brain disorders dwelling in Seoul, South Korea were chosen and medical specialists investigated all of the subjects with the developed tools.

Results

The HNA tool for brain disorders we developed included four categories: 1) medical interventions and operations, 2) assistive devices, 3) rehabilitation therapy, and 4) regular follow-up. This study also found that 71.9% of the subjects did not receive appropriate medical care, which implies that the severity of their disability is likely to be exacerbated and permanent, and the loss irrecoverable.

Conclusions

Our results showed that the HNA tool for persons with brain disorders based on unmet needs defined by physicians can be a useful method for evaluating the appropriateness and necessity of medical services offered to the disabled, and it can serve as the norm for providing health care services for disabled persons. Further studies should be undertaken to increase validity and reliability of the tool. Fundamental research investigating the factors generating or affecting the unmet needs is necessary; its results could serve as basis for developing policies to eliminate or alleviate these factors.

Summary
Differences in Obesity Rates Between People With and Without Disabilities and the Association of Disability and Obesity: A Nationwide Population Study in South Korea
Moo-Kyung Oh, Hyeongap Jang, Yong-Ik Kim, Belong Jo, Yoon Kim, Jong-Heon Park, Jin-Seok Lee
J Prev Med Public Health. 2012;45(4):211-218.   Published online July 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.4.211
  • 9,570 View
  • 71 Download
  • 14 Crossref
AbstractAbstract PDF
Objectives

The objective of this study was to identify the differences in obesity rates among people with and without disabilities, and evaluate the relationship between obesity rates and the existence of disabilities or characteristics of disabilities.

Methods

Mass screening data from 2008 from the National Disability Registry and National Health Insurance (NHI) are used. For analysis, we classified physical disability into three subtypes: upper limb disability, lower limb disability, and spinal cord injury. For a control group, we extracted people without disabilities by each subtype. To adjust for the participation rate in the NHI mass screening, we calculated and adopted the weight stratified by sex, age, and grade of disability. Differences in obesity rates between people with and without disabilities were examined by a chi-squared test. In addition, the effect of the existence of disabilities and grade of disabilities on obesity was examined by multiple logistic regression analysis.

Results

People with disabilities were found to have a higher obesity rate than those without disabilities. The obesity rates were 35.2% and 35.0% (people with disabilities vs. without disabilities) in the upper limb disability, 44.5% and 34.8% in the lower limb disability, 43.4% and 34.6% in the spinal cord injury. The odds for existence of physical disability and grade of disability are higher than the non-disabilities.

Conclusions

These results show that people with physical disability have a higher vulnerability to obesity.

Summary

Citations

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    Obesity Science & Practice.2024;[Epub]     CrossRef
  • Health-related Physical Fitness, Blood Pressure, and Body Mass Index among People with Intellectual Disability, Visual Impairment, and Hearing Impairment
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    Exercise Science.2024; 33(1): 93.     CrossRef
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    Julianne G. Clina, Cassandra Herman, Christine C. Ferguson, James H. Rimmer
    Disability and Health Journal.2023; 16(3): 101447.     CrossRef
  • Investigation of the Relationship Between Psychiatry Visit and Suicide After Deliberate Self-harm: Longitudinal National Cohort Study
    Hye Hyeon Kim, Chanyoung Ko, Ji Ae Park, In Han Song, Yu Rang Park
    JMIR Public Health and Surveillance.2023; 9: e41261.     CrossRef
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    Journal of Korean Medicine for Obesity Research.2019; 19(1): 68.     CrossRef
  • Association of employment status and income with self-rated health among waged workers with disabilities in South Korea: population-based panel study
    Jae Woo Choi, Juyeong Kim, Euna Han, Tae Hyun Kim
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    Jeroen S. de Munter, Per Tynelius, Gerd Ahlström, Finn Rasmussen
    Disability and Health Journal.2016; 9(4): 632.     CrossRef
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    Sungmin Son, Byoungjin Jeon, Heejung Kim
    Journal of Physical Therapy Science.2016; 28(3): 788.     CrossRef
  • Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden
    Marianne Holmgren, Anna Lindgren, Jeroen de Munter, Finn Rasmussen, Gerd Ahlström
    BMC Public Health.2014;[Epub]     CrossRef
  • Comparison of sarcopenic status between elderly leprosy survivors and general population
    Won Kim, Hee Won Park, Byung Kwan Hwang, Soon Ook Bae, In Kwon Kim, Sun G. Chung
    Archives of Gerontology and Geriatrics.2014; 58(1): 134.     CrossRef
  • Recent Developments in Obesity Research: Linkages between Obesity, Disability, and Physical Functioning
    Sandra L. Reynolds
    Current Obesity Reports.2013; 2(3): 267.     CrossRef
English Abstracts
The Medical Use of the Disabled Among Overusers of Medical Aid in Korea.
Sun Mi Shin, Eui Sook Kim, Chang Ki Park, Hee Woo Lee
J Prev Med Public Health. 2010;43(1):35-41.
DOI: https://doi.org/10.3961/jpmph.2010.43.1.35
  • 5,349 View
  • 49 Download
  • 5 Crossref
AbstractAbstract PDF
OBJECTIVES
In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. METHODS: Subjects (n=2,211) selected were > or =18-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. RESULTS: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(won), inpatient payment of 359,000won, and outpatient payment of 183,000won. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (82,000won), elementary school or lower educational level (64,000won), residence in a small city (82,000won), lack of family support (61,000won), kidney disability (673,000won), intellectual disability (151,000won), and multiple disabilities (119,000won). CONCLUSIONS: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.
Summary

Citations

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  • Why don't Chinese college students seek help from the National Health Service (NHS)? Chinese college students' use of medical services in the UK
    Zheng Yang, Yuanting Huang
    Heliyon.2024; 10(18): e37879.     CrossRef
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    Sun Mi Shin, Hee Woo Lee
    International Journal for Equity in Health.2021;[Epub]     CrossRef
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    Young Dae Kwon, Hyejung Chang, Youn Jung Choi, Sung Sang Yoon
    Journal of the Korean Medical Association.2012; 55(10): 1014.     CrossRef
  • Multilevel Analysis of Health Care Service Utilization among Medical Aid Beneficiaries in Korea
    Yang Heui Ahn, Ok Kyung Ham, Soo Hyun Kim, Chang Gi Park
    Journal of Korean Academy of Nursing.2012; 42(7): 928.     CrossRef
  • Factors Associated With the Overuse or Underuse of Health Care Services Among Medical Aid Beneficiaries in Korea
    Yang Heui Ahn, Eui Sook Kim, Ok Kyung Ham, Soo Hyun Kim, Seung Sik Hwang, Sang Hee Chun, Na Yeon Gwon, Jin Yi Choi
    Journal of Community Health Nursing.2011; 28(4): 190.     CrossRef
Antihypertensive Drug Medication Adherence of People with Disabilities and its Affecting Factors in Korea.
Jong Hyock Park, Youngsoo Shin, Sang Yi Lee, Jae Hyun Park
J Prev Med Public Health. 2007;40(3):249-258.
DOI: https://doi.org/10.3961/jpmph.2007.40.3.249
  • 4,917 View
  • 68 Download
  • 8 Crossref
AbstractAbstract PDF
OBJECTIVES
The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. METHODS: The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. RESULTS: The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence (CMA > or =80%) rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. CONCLUSIONS: The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.
Summary

Citations

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    Han-Kil Kang, Nak-Jin Sung
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    Sangyong Jo, Taegyu Um, Jihye Shin, Dongchan Lee, Kyungil Park, Minkook Son
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  • Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension


    Hyemin Cho, Sohyun Jeong, Cinoo Kang, Hee-Jin Kang, Suhyun Jang, Sunmee Jang
    Patient Preference and Adherence.2020; Volume 14: 2123.     CrossRef
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    International Journal on Disability and Human Development.2015;[Epub]     CrossRef
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    Hypertension Research.2013; 36(11): 1000.     CrossRef
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    Journal of the Korean Medical Association.2013; 56(3): 184.     CrossRef
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Original Articles
Structural Relationships among Health Concern, Health Practice and Health Status of the Disabled.
Ki Soo Park, Byung Yeol Chun, Sin Kam, Min Hae Yeh, Yun Sik Kang, Keon Yeop Kim, Jae Hee Son, Young Suk Lee
Korean J Prev Med. 1999;32(3):276-288.
  • 2,231 View
  • 25 Download
AbstractAbstract PDF
OBJECTIVES
This study was performed to determine the relationships among Health concern, health practice and health status of the disabled. METHODS: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. RESULTS: Health concern had a significant and positive relationship with health practice(p<0.05) and health practice also had a significant and positive relationship with self-rated health status(p<0.05) in men and women. To determine the structural model of the Health concern, health practice, health status and sociodemographic variables, the covariance structural analysis was used. In men, age, economic status, medical security type, educational level and type of disability had significant direct effects on Health concern(T>2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect on health status(T>2.0). In men and women, health practice was significantly increased with increasing Health concern and the more health practice, the higher health status(T>2.0). CONCLUSIONS: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.
Summary
Quality of Life(QOL), Life Satisfaction, and Its Determinents of the Physically Disabled in Taegu City .
Youg Sook Lee, Keon Yeop Kim, Ki Soo Park, Jae Hee Son, Jong Young Lee
Korean J Prev Med. 1998;31(3):503-515.
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AbstractAbstract PDF
In order to investigate the factors influencing QOL and life satisfaction of the physically disabled, the author interviewed, by using structuralized questionnaire, 440 individuals among the physically disabled who were participated in Health Examination from April to July, 1997. The questionnaire consisted of the general characteristics(sex, age, marital status, family number, etc), the Reintegration to Normal Living Index(RNLI) to assess QOL, and the single item of five-likert scale to evaluate life satisfaction. The means of RNLI were 16.2+/-4.8 in total score, 12.2+/-3.4 in daily functioning and 4.0+/-2.1 in perception of self. The respondents were less reintegrated toward social activities and relationships than impairments or disabilities. While the satisfied group was 47.3%, the dissatisfied group was 52.7%. As the results of multiple regression and logistic regression analysis, the significant predictors of QOL were age, education, job, grade of disability and subjective health status. The life satisfaction were related to economic status, job and subjective health status. To improve QOL and life satisfaction of the physically disabled, it is important that we improve their basic socioeconomic status by getting a job through rehabilitation education and induce them to have positive self-assessment by extending the opportunity of social participation.
Summary
Determinanats of Health Care Utilization of the Physically Disabled.
Keon Yeop Kim, Young Sook Lee, Ki Soo Park, Jae Hee Son, Sin Kam, Byung Yeol Chun, Jae Yong Park, Min Hae Yeh
Korean J Prev Med. 1998;31(2):323-334.
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AbstractAbstract PDF
To investigate determinants of health care utilization of the physically, disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization rate was 81.9%(69.l% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically, significant relationship with health care utilization(p<0.05). By, path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.l%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health Concern toward physically disabled should be implemented to increase health care utilization rate.
Summary
English Abstract
Factors Affecting National Health Insurance Mass Screening Participation in the Disabled.
Jong Hyock Park, Jin Seok Lee, Jin Yong Lee, Ji Young Hong, So Young Kim, Seong Ok Kim, Byong Hee Cho, Yong Ik Kim, Youngsoo Shin, Yoon Kim
J Prev Med Public Health. 2006;39(6):511-519.
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  • 50 Download
AbstractAbstract PDF
OBJECTIVES
As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the nondisabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the nondisabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. METHODS: In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income; disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. RESULTS: The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan regions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health insurance program for the self-employed than for employees (95% CI=2.56-2.63); 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23); 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI= 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). CONCLUSIONS: The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.
Summary
Comparative Study
Differences in Medical Care Utilization Rates of the Disabled and the Non-disabled with Ambulatory Care Sensitive Conditions.
Sang Jun Eun, Jee Young Hong, Jin Yong Lee, Jin Seok Lee, Yoon Kim, Yong Ik Kim, Youngsoo Shin
J Prev Med Public Health. 2006;39(5):411-418.
  • 2,451 View
  • 62 Download
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. METHODS: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. RESULTS: The numbers of physician visits per 100 patients were 0.78~0.97 times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were 1.16~1.77 times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: 0.44~0.70), and the ORs of hospitalization for the disabled were significantly higher (OR: 1.16~1.89). The lower physician visit group (number of physician visits < or =1) was more likely to be hospitalized than the higher physician visit group (number of physician visits > or =2) (OR: 1.69~19.77). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. CONCLUSIONS: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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