Han, Kyu-Tae; Kim, SeungJu
International journal of environmental research and public health
2021Jan ; 18 ( 2 ) :.
PMID : 33440700
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Han, Kyu-Tae - Division of Cancer Control and Policy, National Cancer Center, Goyang 10408, Korea.
Kim, SeungJu - 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.
keyword
cardiovascular disease; dyslipidemia; health disparities; health expenditure; regional disparities
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