Kyu-Tae Han1, SeungJu Kim2. 1. Division of Cancer Control and Policy, National Cancer Center, Goyang 10408, Korea. 2. Department of Nursing, College of Nursing, Eulji University, Seongnam 13135, Korea.
Abstract
BACKGROUND: Health disparities between different populations have long been recognized as a problem, and they are still an unsolved public health issue. Many factors can make a difference, and disparities for cardiovascular diseases (CVDs) are especially pronounced. This study aimed to assess South Korean regional variations for dyslipidemia prevalence, differences in healthcare utilization, and CVD risk. METHODS: We used data from 52,377 patients from the National Health Insurance Sampling. Outcome variables were the risk of CVD, healthcare utilization (outpatient visits), and healthcare expenditures. A generalized estimating equation model was used to identify associations between the region and CVD risk, a Poisson regression model was used for evaluating outpatient visits, and a generalized linear model (gamma and log link function) was used to evaluate healthcare expenditures. RESULTS: A total of 12,443 (23.8%) patients were diagnosed with CVD. Dyslipidemia prevalence varied by region, and the most frequent dyslipidemia factor was high total cholesterol. CVD risk was increased in low population-density regions compared to high-density regions (odds ratio [OR]: 1.133, 95% confidence interval [CI]: 1.037-1.238). Healthcare expenditures and outpatient visits were also higher in low-density regions compared to high-density regions. CONCLUSIONS: This study provides a regional assessment of dyslipidemia prevalence, healthcare utilization, and CVD risk. To bridge differences across regions, consideration should be given not only to general socio-economic factors but also to specific regional factors that can affect these differences, and a region-based approach should be considered for reducing disparities in general health and healthcare quality.
BACKGROUND: Health disparities between different populations have long been recognized as a problem, and they are still an unsolved public health issue. Many factors can make a difference, and disparities for cardiovascular diseases (CVDs) are especially pronounced. This study aimed to assess South Korean regional variations for dyslipidemia prevalence, differences in healthcare utilization, and CVD risk. METHODS: We used data from 52,377 patients from the National Health Insurance Sampling. Outcome variables were the risk of CVD, healthcare utilization (outpatient visits), and healthcare expenditures. A generalized estimating equation model was used to identify associations between the region and CVD risk, a Poisson regression model was used for evaluating outpatient visits, and a generalized linear model (gamma and log link function) was used to evaluate healthcare expenditures. RESULTS: A total of 12,443 (23.8%) patients were diagnosed with CVD. Dyslipidemia prevalence varied by region, and the most frequent dyslipidemia factor was high total cholesterol. CVD risk was increased in low population-density regions compared to high-density regions (odds ratio [OR]: 1.133, 95% confidence interval [CI]: 1.037-1.238). Healthcare expenditures and outpatient visits were also higher in low-density regions compared to high-density regions. CONCLUSIONS: This study provides a regional assessment of dyslipidemia prevalence, healthcare utilization, and CVD risk. To bridge differences across regions, consideration should be given not only to general socio-economic factors but also to specific regional factors that can affect these differences, and a region-based approach should be considered for reducing disparities in general health and healthcare quality.
Entities:
Keywords:
cardiovascular disease; dyslipidemia; health disparities; health expenditure; regional disparities
Authors: Tanjala S Purnell; Elizabeth A Calhoun; Sherita H Golden; Jacqueline R Halladay; Jessica L Krok-Schoen; Bradley M Appelhans; Lisa A Cooper Journal: Health Aff (Millwood) Date: 2016-08-01 Impact factor: 6.301
Authors: Duck-Chul Lee; Xuemei Sui; Timothy S Church; Carl J Lavie; Andrew S Jackson; Steven N Blair Journal: J Am Coll Cardiol Date: 2012-02-14 Impact factor: 24.094
Authors: Raul Vinueza; Carlos Pablo Boissonnet; Monica Acevedo; Felipe Uriza; Francisco Jose Benitez; Honorio Silva; Herman Schargrodsky; Beatriz Champagne; Elinor Wilson Journal: Prev Med Date: 2009-12-23 Impact factor: 4.018
Authors: Adil Supiyev; Talgat Nurgozhin; Zhaxybay Zhumadilov; Anne Peasey; Jaroslav A Hubacek; Martin Bobak Journal: BMC Public Health Date: 2017-08-11 Impact factor: 3.295
Authors: Kevin A Matthews; Janet B Croft; Yong Liu; Hua Lu; Dafna Kanny; Anne G Wheaton; Timothy J Cunningham; Laura Kettel Khan; Ralph S Caraballo; James B Holt; Paul I Eke; Wayne H Giles Journal: MMWR Surveill Summ Date: 2017-02-03