Korean J Fam Med 2017; 38(4): 220-225  https://doi.org/10.4082/kjfm.2017.38.4.220
Disparity in Health Screening and Health Utilization according to Economic Status
Min Jung Kim, Hyejin Lee*, Eun Ha Kim, Mi Hee Cho, Dong Wook Shin, Jae Moon Yun, Jung-Hyun Shin
Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Korea
Hyejin Lee Tel: +82-2-2072-4013, Fax: +82-2-766-3276, E-mail: jie2128@gmail.com
Received: March 4, 2016; Revised: August 30, 2016; Accepted: September 1, 2016; Published online: July 20, 2017.
© Korean Academy of Family Medicine. All rights reserved.

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Abstract
Background: Cardiovascular disease (CVD) has become the most common cause of mortality and morbidity worldwide. Health screening is associated with higher outpatient visits for detection and treatment of CVD-related diseases (diabetes mellitus, hypertension, and dyslipidemia). We examined the association between health screening, health utilization, and economic status.
Methods: A sampled cohort database from the National Health Insurance Corporation was used. We included 306,206 participants, aged over 40 years, without CVD (myocardial infarction, stroke, and cerebral hemorrhage), CVD-related disease, cancer, and chronic renal disease. The follow-up period was from January 1, 2003 through December 31, 2005.
Results: Totally, 104,584 participants received at least one health screening in 2003–2004. The odds ratio of the health screening attendance rate for the five economic status categories was 1.27 (95% confidence interval [CI], 1.24 to 1.31), 1.05 (95% CI, 1.02 to 1.08), 1, 1.16 (95% CI, 1.13 to 1.19) and 1.50 (95% CI, 1.46 to 1.53), respectively. For economic status 1, 3, and 5, respectively, the diagnostic rate after health screening was as follows: diabetes mellitus: 5.94%, 5.36%, and 3.77%; hypertension: 32.75%, 30.16%, and 25.23%; and dyslipidemia: 13.43%, 12.69%, and 12.20%. The outpatient visit rate for attendees diagnosed with CVD-related disease was as follows for economic status 1, 3, and 5, respectively: diabetes mellitus: 37.69%, 37.30%, and 43.70%; hypertension: 34.44%, 30.09%, and 32.31%; and dyslipidemia: 18.83%, 20.35%, and 23.48%.
Conclusion: Thus, higher or lower economic status groups had a higher health screening attendance rate than the middle economic status group. The lower economic status group showed lower outpatient visits after screening, although it had a higher rate of CVD diagnosis.
Keywords: Economic Status; Mass Screening; Health Utilization; Cardiovascular Diseases


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