Yang Jeong Min, Hwang Jieun
Department of Public Health, General Graduate School of Dankook University, Cheonan, Korea.
Institute of Convergence Healthcare, Dankook University, Cheonan, Korea.
J Prev Med Public Health. 2024 Nov;57(6):540-551. doi: 10.3961/jpmph.24.232. Epub 2024 Sep 23.
This study aimed to identify trends in avoidable mortality (AVM) in 16 provincial and metropolitan regions of Korea and determine the factors influencing AVM.
First, the avoidable mortality rate (AVMR) was calculated using the Statistics Korea cause-of-death and population data by age and region from 2013 to 2022. Second, a health determinants model was built, and we identified the factors influencing AVM using generalized estimating equations analysis.
Although the AVMR per 100 000 people displayed a steadily decreasing trend from 2013 to 2020, it began to increase in 2021. Meanwhile, Jeonnam, Jeonbuk, Gyeongnam, Gyeongbuk, Chungnam, Chungbuk, and Gangwon Provinces showed a higher AVMR than the national average. The analysis revealed that each 1-unit increase in the older adult population, smoking, perceived stress, or non-local medical utilization was associated with an increase in the AVMR. Conversely, 1-unit increases in the male-to-female ratio, marriage rate, positive self-rated health, local medical utilization, doctor population, influenza vaccination rate, cancer screening rate, or financial independence were associated with decrease in the AVMR.
This study established that the AVMR, which had been continuously decreasing across the 16 regions, shifted to an increasing trend in 2021. We also identified several factors influencing AVM. Further studies are needed to confirm the reasons for this shift in the AVMR and explore the factors that influence AVM across Korea's 16 provincial and metropolitan regions.
本研究旨在确定韩国16个省和直辖市可避免死亡率(AVM)的趋势,并确定影响可避免死亡率的因素。
首先,利用韩国统计局2013年至2022年按年龄和地区划分的死因和人口数据计算可避免死亡率(AVMR)。其次,建立了一个健康决定因素模型,并使用广义估计方程分析确定影响可避免死亡率的因素。
尽管每10万人的可避免死亡率从2013年到2020年呈稳步下降趋势,但在2021年开始上升。同时,全罗南道、全罗北道、庆尚南道、庆尚北道、忠清南道、忠清北道和江原道的可避免死亡率高于全国平均水平。分析表明,老年人口、吸烟、感知压力或非本地医疗利用率每增加1个单位,可避免死亡率就会增加。相反,男女比例、结婚率、自我健康评价良好、本地医疗利用率、医生人口、流感疫苗接种率、癌症筛查率或经济独立每增加1个单位,可避免死亡率就会降低。
本研究确定,16个地区持续下降的可避免死亡率在2021年转变为上升趋势。我们还确定了几个影响可避免死亡率的因素。需要进一步研究来确认可避免死亡率这种转变的原因,并探索影响韩国16个省和直辖市可避免死亡率的因素。