Division of Cancer Control and Policy, National Cancer Center, Goyang 10408, Korea.
Department of Nursing, College of Nursing, Eulji University, Seongnam 13135, Korea.
Int J Environ Res Public Health. 2021 Jan 11;18(2):538. doi: 10.3390/ijerph18020538.
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.
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.
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.
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.
不同人群之间的健康差异长期以来一直被认为是一个问题，而且仍然是一个未解决的公共卫生问题。许多因素都可能产生影响，心血管疾病（CVD）的差异尤为明显。本研究旨在评估韩国地区血脂异常患病率的差异、医疗保健利用的差异以及 CVD 风险。
我们使用了来自国家健康保险抽样的 52377 名患者的数据。结局变量是 CVD 风险、医疗保健利用（门诊就诊）和医疗保健支出。使用广义估计方程模型来确定地区与 CVD 风险之间的关联，使用泊松回归模型来评估门诊就诊，使用广义线性模型（伽马和对数链接函数）来评估医疗保健支出。
共有 12443 名（23.8%）患者被诊断为 CVD。血脂异常的患病率因地区而异，最常见的血脂异常因素是高总胆固醇。与高密度地区相比，低密度地区的 CVD 风险增加（优势比[OR]：1.133，95%置信区间[CI]：1.037-1.238）。低密度地区的医疗保健支出和门诊就诊也高于高密度地区。
本研究提供了血脂异常患病率、医疗保健利用和 CVD 风险的地区评估。为了弥合各地区之间的差异，不仅应考虑一般社会经济因素，还应考虑可能影响这些差异的特定地区因素，应考虑采取基于地区的方法来减少一般健康和医疗保健质量方面的差异。
