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Original Articles
- 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
- Eun Jee Park, Nam Ju Ji, Chang Hoon You, Weon Young Lee
- J Prev Med Public Health. 2024;57(5):471-479. Published online August 20, 2024
- DOI: https://doi.org/10.3961/jpmph.24.165
- 6,979 View
- 248 Download
- 2 Web of Science
- 2 Crossref
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Abstract
Summary
PDF - 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. -
SummaryKorean 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. -
Citations
Citations to this article as recorded by
- Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(2): 183. CrossRef - Long-term clinical outcome and risk stratification across stages of cardiovascular-kidney-metabolic syndrome in a nationwide cohort
Hyun-Jin Kim, Byung Sik Kim, Hasung Kim, Jungkuk Lee, Ha Hye Jo, Dong Wook Kim, Jeong-Hun Shin, Ki-Chul Sung
The Korean Journal of Internal Medicine.2025; 40(6): 975. CrossRef
- Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
- Identifying, Measuring, and Ranking Social Determinants of Health for Health Promotion Interventions Targeting Informal Settlement Residents
- Farhad Nosrati Nejad, Mohammad Reza Ghamari, Seyed Hossein Mohaqeqi Kamal, Seyed Saeed Tabatabaee
- J Prev Med Public Health. 2023;56(4):327-337. Published online June 26, 2023
- DOI: https://doi.org/10.3961/jpmph.23.059
- 6,203 View
- 196 Download
- 1 Web of Science
- 1 Crossref
-
Abstract
PDF
- Objectives
Considering the importance of social determinants of health (SDHs) in promoting the health of residents of informal settlements and their diversity, abundance, and breadth, this study aimed to identify, measure, and rank SDHs for health promotion interventions targeting informal settlement residents in a metropolitan area in Iran.
Methods
Using a hybrid method, this study was conducted in 3 phases from 2019 to 2020. SDHs were identified by reviewing studies and using the Delphi method. To examine the SDHs among informal settlement residents, a cross-sectional analysis was conducted using researcher-made questionnaires. Multilayer perceptron analysis using an artificial neural network was used to rank the SDHs by priority.
Results
Of the 96 determinants identified in the first phase of the study, 43 were examined, and 15 were identified as high-priority SDHs for use in health-promotion interventions for informal settlement residents in the study area. They included individual health literacy, nutrition, occupational factors, housing-related factors, and access to public resources.
Conclusions
Since identifying and addressing SDHs could improve health justice and mitigate the poor health status of settlement residents, ranking these determinants by priority using artificial intelligence will enable policymakers to improve the health of settlement residents through interventions targeting the most important SDHs. -
Summary
Citations
Citations to this article as recorded by- The data scientist as a mainstay of the tumor board: global implications and opportunities for the global south
Myles Joshua Toledo Tan, Daniel Andrew Lichlyter, Nicholle Mae Amor Tan Maravilla, Weston John Schrock, Frederic Ivan Leong Ting, Joanna Marie Choa-Go, Kishi Kobe Francisco, Mickael Cavanaugh Byers, Hezerul Abdul Karim, Nouar AlDahoul
Frontiers in Digital Health.2025;[Epub] CrossRef
Scoping Review- The Most Important Social Determinants of Slum Dwellers’ Health: A Scoping Review
- Farhad Nosrati Nejad, Mohammad Reza Ghamari, Seyed Hossein Mohaqeqi Kamal, Seyed Saeed Tabatabaee, Raheleh Ganjali
- J Prev Med Public Health. 2021;54(4):265-274. Published online July 8, 2021
- DOI: https://doi.org/10.3961/jpmph.21.073
- 11,497 View
- 283 Download
- 14 Web of Science
- 16 Crossref
-
Abstract
PDF
- Objectives
Given the importance of social determinants of health in promoting the health of slum residents, this study was conducted with the aim of identifying the main dimensions and components of these determinants.
Methods
This scoping review study was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A comprehensive search was performed of PubMed, ProQuest, Scopus, and Web of Science for articles conducted from 2010 to the end of 2019. Studies were selected based on inclusion criteria, with a special focus on studies dealing with the social determinants of physical and mental health or illness.
Results
Thirty-three articles were selected to extract information on the social determinants of health. After reviewing the articles, 7 main dimensions (housing, socioeconomic status of the family, nutrition, neighborhood characteristics, social support and social capital, occupational factors, and health behaviors) and 87 components were extracted as social determinants of health among slum dwellers.
Conclusions
This framework could be used by planners, managers, and policy-makers when making decisions affecting the health of these settlements’ residents due to the common characteristics of slums around the world, especially in developing countries. -
Summary
Citations
Citations to this article as recorded by- A pathways framework for the climate change-mental health-violence nexus in informal settlements
Samantha C. Winter
Urban Climate.2026; 66: 102844. CrossRef - Household determinants of healthcare utilisation in three informal settlements in Freetown, Sierra Leone: a cross-sectional survey
Samira Sesay, Ibrahim Juldeh Sesay, Sia Morenike Tengbe, Haja Wurie, Sullaiman Fullah, Dora Vangahun, Ibrahim Gandi, Noemia Teixeira de Siqueira Filha, Rajith W D Lakshman, Abu Conteh, Samuel Saidu, Braima Koroma, Bintu Mansaray, Helen Elsey, Lana Whittak
BMJ Open.2026; 16(3): e108022. CrossRef - Determining a Likely Mechanism of Missingness in Repeated Measures Sleep Data From Wearable Fitness Trackers: Longitudinal Analysis
Kate Mobley, Kevin B Gittner, Karen Nielsen, Lauren M Matheny, Gita Taasoobshirazi, Charles Natuhamya, Monica H Swahn
JMIR mHealth and uHealth.2026; 14: e81123. CrossRef - Mental health and post-traumatic stress among unprivileged people in the aftermath of COVID-19 pandemic in Southwest Bangladesh: a cross-sectional study
Md. Salauddin Khan, Maliha Mahazabin, Ishita Shahid Sams, Lasker Ershad Ali, Umama Khan
Cogent Mental Health.2025;[Epub] CrossRef - Serious psychological distress among slum dwellers and unhoused people in Ho Chi Minh City, Vietnam: a pilot study
Hitoshi Murakami, Nguyen Thuy Linh, Masami Fujita, Lam Ngoc Thuy, Nguyen Hong Phuc, Kieu Thi Mai Huong, Le Tuan Anh, Pham Thi Ngoc Mai, Khuat Thi Hai Oanh
Tropical Medicine and Health.2025;[Epub] CrossRef - Acute Respiratory Tract Infections in Pediatric Populations of Slum Areas: Navigating Challenges and Dynamics of Immune Responses
Gayathri Gunasekaran, Dinesh Kumar Thirugnanam, Ashwath Balasubramaniam, N. Nalini Jayanthi, K.V. Leela
Current Pediatric Reviews.2025; 21(3): 245. CrossRef - Artificial Intelligence and Social Determinants of Health
Vincent Morelli
Primary Care: Clinics in Office Practice.2025; 52(4): 699. CrossRef - Prevalence of chronic non-communicable diseases and multimorbidity among adults living in slums in Rio de Janeiro, Brazil: a population-based survey
Amanda Echeverría-Guevara, Paula M. Luz, Débora C. Pires, Emilia M. Jalil, Hugo Perazzo, Thiago S. Torres, Sandra W. Cardoso, Guilherme T. Goedert, Daniel Csillag, Eduardo M. Peixoto, Breno Augusto Bormann de Souza Filho, Carlos A. M. Costa, Rodrigo T. Am
International Journal for Equity in Health.2025;[Epub] CrossRef - Rethinking Urbanicity: Conceptualizing Neighborhood Effects on Women’s Mental Health in Kampala’s Urban Slums
Monica H. Swahn, Peter Kalulu, Hakimu Sseviiri, Josephine Namuyiga, Jane Palmier, Revocatus Twinomuhangi
International Journal of Environmental Research and Public Health.2025; 23(1): 41. CrossRef - Determinants of food insecurity among slum households of Khulna Division, Bangladesh
Suvasish Das Shuvo, Ambika Charan Mandal, Asma Khatun, Abu Bashar, Deepa Roy
Scientific Reports.2025;[Epub] CrossRef - Deprivation and Its Association with Child Health and Nutrition in the Greater Kampala Metropolitan Area of Uganda
Rornald Muhumuza Kananura, Peter Waiswa, Ronald Wasswa, Ties Boerma, Cauane Blumenberg, Abdoulaye Maiga
Journal of Urban Health.2024; 101(S1): 107. CrossRef - RETRACTED ARTICLE: Urban Spatial Dynamics and
Geo-informatics Prediction of Karachi from 1990–2050 Using Remote Sensing and
CA-ANN Simulation
Shaker Ul Din, Kayoko Yamamoto
Earth Systems and Environment.2024; 8(3): 849. CrossRef - Características da vizinhança em Belo Horizonte, Minas Gerais, Brasil: uma análise intraurbana usando o método de observação social sistemática
Amanda Silva Magalhães, Amanda Cristina de Souza Andrade, Bruno de Souza Moreira, Solimar Carnavalli Rocha, Débora Moraes Coelho, Adalberto Aparecido dos Santos Lopes, Aline Dayrell Ferreira Sales, Amélia Augusta de Lima Friche, Waleska Teixeira Caiaffa
Cadernos de Saúde Pública.2024;[Epub] CrossRef - “For my safety and wellbeing, I always travel to seek health care in a distant facility”—the role of place and stigma in HIV testing decisions among GBMSM – BSGH 002
Edem Yaw Zigah, Gamji Rabiu Abu-Ba'are, Osman Wumpini Shamrock, Henry Delali Dakpui, Amos Apreku, Donte T. Boyd, LaRon E. Nelson, Kwasi Torpey
Health & Place.2023; 83: 103076. CrossRef - Identifying, Measuring, and Ranking Social Determinants of Health for Health Promotion Interventions Targeting Informal Settlement Residents
Farhad Nosrati Nejad, Mohammad Reza Ghamari, Seyed Hossein Mohaqeqi Kamal, Seyed Saeed Tabatabaee
Journal of Preventive Medicine and Public Health.2023; 56(4): 327. CrossRef - Do Community-based Livelihood Interventions Affect Sexual and Reproductive Health and Rights of Young People in Slum Areas of Uganda: a Difference-in-difference with Kernel Propensity Score Matching Analysis
Andre M. N. Renzaho, Joseph K. Kamara, Daniel Doh, Paul Bukuluki, Rashidul A. Mahumud, Moses Galukande
Journal of Urban Health.2022; 99(1): 164. CrossRef
Evaluation Studies- The Effect of Catastrophic Health Expenditure on the Transition to Poverty and the Persistence of Poverty in South Korea.
- Eun Cheol Song, Young Jeon Shin
- J Prev Med Public Health. 2010;43(5):423-435.
- DOI: https://doi.org/10.3961/jpmph.2010.43.5.423
- 8,127 View
- 142 Download
- 19 Crossref
-
Abstract
PDF
- OBJECTIVES
The low benefit coverage rate of South Korea's health security system has been continually pointed out. A low benefit coverage rate inevitably causes catastrophic health expenditure, which can be the cause of the transition to poverty and the persistence of poverty. This study was conducted to ascertain the effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea. METHODS: To determine the degree of social mobility, this study was conducted among the 6311 households that participated in the South Korea Welfare Panel Study in both 2006 and 2008. The effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea was assessed via multiple logistic regression analysis. RESULTS: The poverty rate in South Korea was 21.6% in 2006 and 20.0% in 2008. 25.1 - 7.3% of the households are facing catastrophic health expenditure. Catastrophic health expenditure was found to affect the transition to poverty even after adjusting for the characteristics of the household and the head of the household, at the threshold of 28% or above. CONCLUSIONS: 25.1% of the households in this study were found to be currently facing catastrophic health expenditure, and it was determined that catastrophic health expenditure is a cause of transition to poverty. This result shows that South Korea's health security system is not an effective social safety net. As such, to prevent catastrophic health expenditure and transition to poverty, the benefit coverage of South Korea's health security system needs to the strengthened. -
Summary
Citations
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Eun Jee Chang, Sanggu Kang, Yeri Jeong, Sungchan Kang, Su Jin Kang
Journal of Preventive Medicine and Public Health.2023; 56(1): 67. CrossRef - Food Insecurity, Healthcare Utilization, and Healthcare Expenditures: A Longitudinal Cohort Study
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International Journal of Public Health.2023;[Epub] CrossRef - The effect of catastrophic health expenditure on exit from poverty among the poor in South Korea
Eunkyoung Kim, Soonman Kwon
The International Journal of Health Planning and Management.2021; 36(2): 482. CrossRef - Incidence of household catastrophic and impoverishing health expenditures among patients with Breast Cancer in Iran
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BMC Health Services Research.2021;[Epub] CrossRef - The Effect of Mid-to-Long-Term Hospitalization on the Catastrophic Health Expenditure: Focusing on the Mediating Effect of Earned Income Loss
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Healthcare.2021; 9(8): 1013. CrossRef - The impact of poverty transitions on frailty among older adults in South Korea: findings from the Korean longitudinal study of ageing
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BMC Geriatrics.2020;[Epub] CrossRef - Modelling unbalanced catastrophic health expenditure data by using machine‐learning methods
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Intelligent Systems in Accounting, Finance and Management.2020; 27(4): 168. CrossRef - Relationship Between Catastrophic Health Expenditures and Income Quintile Decline
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