Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Psychiatry Res. 2017 Dec;258:358-364. doi: 10.1016/j.psychres.2017.08.072. Epub 2017 Aug 26.
Problems related to alcohol consumption, particularly alcohol disorders, occur frequently in South Korea and are gradually increasing due to the drinking culture and social atmosphere. We analyzed the relationship between mortality and income among patients with alcohol disorders. We used data from the National Sampling Claim Data 2003-2013, which included medical claims filed for 10,593 patients newly diagnosed with alcohol disorders. We performed survival analyses using a Cox proportional hazards model. 12.79% died during the study period. Patients with lower incomes were more positively associated with the risk of mortality than those with higher incomes (0-30 percentile: hazard ratio [HR] = 1.432, 95% confidence interval [CI] = 1.155-1.777; 31-60 percentile: HR = 1.318, 95% CI = 1.065-1.633; 61-90 percentile: HR = 1.352, 95% CI = 1.097-1.665; 91-100 percentile: ref). Such associations were significant in males, patients with mild conditions, or those who lived in metropolitan areas. In conclusion, we found that income disparity was related to mortality among patients diagnosed with disorders due to alcohol use. Thus, healthcare professionals need to provide active intervention in the early phase of alcohol disorders, and consider policy that would improve healthcare accessibility for low-income populations in order to reduce income disparity.
在韩国,与酒精消费相关的问题,特别是酒精障碍,经常发生,并由于饮酒文化和社会氛围的影响而逐渐增加。我们分析了酒精障碍患者的死亡率与收入之间的关系。我们使用了 2003-2013 年国家抽样索赔数据,其中包括 10593 名新诊断为酒精障碍患者的医疗索赔。我们使用 Cox 比例风险模型进行生存分析。在研究期间,有 12.79%的患者死亡。与高收入患者相比,低收入患者的死亡率风险更高(0-30 百分位:风险比 [HR] = 1.432,95%置信区间 [CI] = 1.155-1.777;31-60 百分位:HR = 1.318,95%CI = 1.065-1.633;61-90 百分位:HR = 1.352,95%CI = 1.097-1.665;91-100 百分位:参考)。这种关联在男性、病情较轻的患者或居住在大都市地区的患者中更为显著。总之,我们发现收入差距与因酒精使用障碍而确诊的患者的死亡率有关。因此,医疗保健专业人员需要在酒精障碍的早期阶段提供积极干预,并考虑改善低收入人群获得医疗保健的政策,以减少收入差距。