[韩国社区社会经济因素与下尿路症状及良性前列腺增生医疗利用的关系]

[Relationship of socioeconomic factors with medical utilization for lower urinary tract symptoms and benign prostatic hyperplasia in a South Korean community].

作者信息

Kim Han-Hae, Kong Kyoung Ae, Lee Hun Jae, Yoon Hana, Lee Bo Eun, Moon Ok-Ryun, Park Hyesook

机构信息

Korea Institute for Health and Social Affairs.

出版信息

J Prev Med Public Health. 2006 Mar;39(2):141-8.

PMID:16615269

Abstract

OBJECTIVES

We wanted to evaluate the medical underutilization for benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) among Korean elderly men and we wanted to determine their associated factors.

METHODS

This study was conducted on 239 men with LUTS and 116 men with BPH who were compatible with the diagnostic criteria from a total of 641 participants. These participants were over 50 years old and they were randomly chosen in a community-based study for estimating the prevalence of BPH. Using a self-reported questionnaire, we surveyed the sociodemographics, health status, quality of life, lower urinary tract symptoms, medical utilization and reasons for not seeking treatment.

RESULTS

Only 27.6% of the men with LUTS and 31.0% of the men with BPH reported having visited a doctor for urinary symptoms. The reasons for not visiting a doctor were, in order of responses from the group with LUTS: 'considered the symptoms as a part of the normal ageing process', 'not enough time to visit a doctor', 'financial difficulty' and 'the symptoms were not severe or bothersome'. Regarding BPH, the responses were the same as those of the group with LUTS however, 'financial difficulty' placed second. Among the men with experience of visiting a doctor for urinary symptoms, 33.3% of those with LUTS and 28.1% of those with BPH were not treated. The most common reason in both groups was 'the symptoms were not severe to be treated'. On a multiple logistic regression analysis, the larger size household (odds ratio (OR) 3.03, 95% confidence interval (Cl) = 1.40-6.54) and an unsatisfactory quality of life related with urinary symptoms (OR 2.98, 95% CI = 1.23-7.21) were associated with medical utilization in the group of LUTS. For BPH, the current employment status was related with the medical utilization (OR 2.80, 95% CI = 1.10-7.11), in addition to the larger size household (OR 3.24, 95% CI = 1.14-9.21).

CONCLUSIONS

Many men with urinary symptoms do not visit a doctor. This medical underutilization for people with LUTS and BPH may be associated with economic status in Korea.

摘要

目的

我们希望评估韩国老年男性中良性前列腺增生（BPH）和下尿路症状（LUTS）的医疗服务利用不足情况，并确定其相关因素。

方法

本研究对641名参与者中符合诊断标准的239名LUTS男性和116名BPH男性进行。这些参与者年龄超过50岁，是在一项基于社区的研究中随机选取的，以估计BPH的患病率。我们使用一份自我报告问卷，调查了社会人口统计学、健康状况、生活质量、下尿路症状、医疗服务利用情况以及未寻求治疗的原因。

结果

只有27.6%的LUTS男性和31.0%的BPH男性报告因尿路症状看过医生。未看医生的原因，按LUTS组的回答顺序为：“认为症状是正常衰老过程的一部分”、“没有足够时间看医生”、“经济困难”以及“症状不严重或不困扰”。对于BPH，回答与LUTS组相同，不过“经济困难”排在第二位。在有因尿路症状看医生经历的男性中，33.3%的LUTS患者和28.1%的BPH患者未接受治疗。两组中最常见的原因都是“症状不严重无需治疗”。在多因素逻辑回归分析中，家庭规模较大（比值比（OR）3.03，95%置信区间（Cl）=1.40 - 6.54）以及与尿路症状相关的生活质量不满意（OR 2.98，95% CI = 1.23 - 7.21）与LUTS组的医疗服务利用有关。对于BPH，除家庭规模较大（OR 3.24，95% CI = 1.14 - 9.21）外，当前就业状况与医疗服务利用有关（OR 2.80，95% CI = 1.10 - 7.11）。