Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
Int J Environ Res Public Health. 2020 Mar 11;17(6):1815. doi: 10.3390/ijerph17061815.
The high cost of treatment for acute respiratory distress syndrome (ARDS) is a concern for healthcare systems, while the impact of patients' socio-economic status on the risk of ARDS-associated mortality remains controversial. This study investigated associations between patients' income at the time of ARDS diagnosis and ARDS-specific mortality rate after treatment initiation. Data from records provided by the National Health Insurance Service of South Korea were used. Adult patients admitted for ARDS treatment from 2013 to 2017 were included in the study. Patients' income in the year of diagnosis was evaluated. A total of 14,600 ARDS cases were included in the analysis. The 30-day and 1-year mortality rates were 48.6% and 70.3%, respectively. In multivariable Cox regression model, we compared income quartiles, showing that compared to income strata Q1, the Q2 ( = 0.719), Q3 ( = 0.946), and Q4 ( = 0.542) groups of income level did not affect the risk of 30-day mortality, respectively. Additionally, compared to income strata Q1, the Q2 ( = 0.762), Q3 ( = 0.420), and Q4 ( = 0.189) strata did not affect the risk of 1-year mortality. Patient income at the time of ARDS diagnosis did not affect the risk of 30-day or 1-year mortality in the present study based on South Korea's health insurance data.
急性呼吸窘迫综合征（ARDS）的治疗费用高昂，这是医疗系统关注的问题，而患者社会经济地位对 ARDS 相关死亡率的影响仍存在争议。本研究调查了 ARDS 诊断时患者收入与治疗开始后 ARDS 特异性死亡率之间的关系。研究数据来自韩国国家健康保险服务提供的记录。纳入了 2013 年至 2017 年因 ARDS 治疗而住院的成年患者。评估了患者在诊断当年的收入。共纳入了 14600 例 ARDS 病例进行分析。30 天和 1 年的死亡率分别为 48.6%和 70.3%。在多变量 Cox 回归模型中，我们比较了收入四分位数，结果表明，与收入阶层 Q1 相比，Q2（=0.719）、Q3（=0.946）和 Q4（=0.542）的收入水平分别不会影响 30 天死亡率的风险。此外，与收入阶层 Q1 相比，Q2（=0.762）、Q3（=0.420）和 Q4（=0.189）的收入阶层并不影响 1 年死亡率的风险。根据韩国医疗保险数据，本研究发现 ARDS 诊断时患者的收入并不影响 30 天或 1 年死亡率的风险。
