Yun Choa, Park Minah, Joo Jae Hong, Kang Soo Hyun, Jeong Sung Hoon, Nam Chung-Mo, Park Eun-Cheol, Jang Sung-In
Department of Biostatistics and Computing, College of Medicine, Yonsei University, Seoul, Republic of Korea.
Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
Front Med (Lausanne). 2023 Jun 2;10:1138017. doi: 10.3389/fmed.2023.1138017. eCollection 2023.
Complications associated with hypertension can be alleviated by providing necessary medical services. However, there may be disparities in their provision depending on regional differences. Thus, this study aimed to examine the effects of regional healthcare disparities on complications in patients with hypertension in South Korea.
Data from the National Health Insurance Service National Sample Cohort (2004-2019) were analyzed. The position value for the relative composite index was used to identify medically vulnerable regions. The diagnosis of hypertension within the region was also considered. The risk of complications associated with hypertension included cardiovascular, cerebrovascular, and kidney diseases. Cox proportional hazards models were used for statistical analysis.
A total of 246,490 patients were included in this study. Patients who lived in medically vulnerable regions and were diagnosed outside their residential area had a higher risk of complications than those living in non-vulnerable regions and were diagnosed outside the residential area (hazard ratio: 1.156, 95% confidence interval: 1.119-1.195).
Patients living in medically vulnerable regions who were diagnosed outside their residential areas were more likely to have hypertension complications regardless of the type of complication. Necessary policies should be implemented to reduce regional healthcare disparities.
通过提供必要的医疗服务，可以减轻与高血压相关的并发症。然而，根据地区差异，其提供情况可能存在差异。因此，本研究旨在探讨韩国地区医疗保健差异对高血压患者并发症的影响。
分析了国民健康保险服务全国样本队列（2004 - 2019年）的数据。使用相对综合指数的位置值来确定医疗脆弱地区。还考虑了该地区内高血压的诊断情况。与高血压相关的并发症风险包括心血管、脑血管和肾脏疾病。采用Cox比例风险模型进行统计分析。
本研究共纳入246,490例患者。居住在医疗脆弱地区且在其居住地区以外被诊断的患者比居住在非脆弱地区且在居住地区以外被诊断的患者有更高的并发症风险（风险比：1.156，95%置信区间：1.119 - 1.195）。
居住在医疗脆弱地区且在居住地区以外被诊断的患者无论并发症类型如何，都更有可能出现高血压并发症。应实施必要的政策以减少地区医疗保健差异。
