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国家医疗保险和社会经济差异对韩国新生儿听力筛查表现的影响:一项全国性基于人群的评估。

Impact of national health insurance and socioeconomic disparities on newborn hearing screening performance in South Korea: A nationwide population-based evaluation.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea.

Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.

出版信息

Int J Pediatr Otorhinolaryngol. 2024 Jun;181:111969. doi: 10.1016/j.ijporl.2024.111969. Epub 2024 May 10.

Abstract

OBJECTIVES

This study aimed to assess the impact of national health insurance coverage on newborn hearing screening (NHS) outcomes by analyzing hearing questionnaires from the National Infant Health Check-up Program (NIHCP) in South Korea.

METHODS

This study evaluated the performance and referral rates of NHS using nationwide data from 814,875 infants enrolled in the 4-month NIHCP from January 2017 to December 2019. This period encompasses the periods before and after the National Health Insurance in South Korea began covering NHS expenses in October 2018. The study also investigated household income levels to determine their relationship with participation in the NIHCP and NHS outcomes.

RESULTS

The performance of NIHCP increased year-on-year, with NHS performance rates increasing from 88.5 % in 2017 to 91.5 % in 2019. Analysis by household income level revealed that the medical benefit recipients' group had the lowest NHS performance rate of 81.9 % in 2019, whereas that of the higher income level group exceeded 90 %. The NHS referral rate remained consistent at 0.9 % nationally during the study period.

CONCLUSION

The inclusion of NHS in national insurance coverage positively influenced its performance rates across South Korea. Nevertheless, the data indicate the need for more focused and customized support for low-income families to enhance early hearing detection and interventions in newborns and infants.

摘要

目的

本研究旨在通过分析韩国国家婴儿健康检查计划(NIHCP)的听力调查问卷,评估全民健康保险覆盖范围对新生儿听力筛查(NHS)结果的影响。

方法

本研究利用韩国全民健康保险开始承担 NHS 费用前的 2018 年 10 月和后一年即 2019 年的 NHS 814875 名 4 个月 NIHCP 婴儿的全国数据,评估 NHS 的性能和转诊率。该研究还调查了家庭收入水平,以确定其与 NIHCP 和 NHS 结果的参与度之间的关系。

结果

NIHCP 的表现逐年提高, NHS 的表现率从 2017 年的 88.5%上升到 2019 年的 91.5%。按家庭收入水平分析显示,2019 年医疗福利受益人群 NHS 表现率最低,为 81.9%,而较高收入水平人群的 NHS 表现率超过 90%。 NHS 的转诊率在研究期间保持全国 0.9%的水平不变。

结论

NHS 纳入国家保险范围对其在韩国的表现率产生了积极影响。然而,数据表明,需要为低收入家庭提供更有针对性和定制化的支持,以加强新生儿和婴儿的早期听力检测和干预。

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