ABSTRACT
Purpose@#Police officers and firefighters are exposed to risk factors for cerebro-cardiovascular diseases, and the actual risk is expected to increase compared with other occupational groups. The present study aimed to estimate the risks of cerebro-cardiovascular diseases in police officers and firefighters compared to other occupational groups. @*Materials and Methods@#Using the National Health Insurance Service data, we constructed a retrospective cohort of public officers. Three-year consecutive health insurance registration data were used to identify police officers and firefighters. Cerebro-cardiovascular diseases consisted of acute myocardial infarction, other ischemic heart disease, cardiac arrhythmia, and stroke. We compared the incidences of cerebro-cardiovascular diseases between each of the two occupational groups (police officers and firefighters) and other public officers by calculating standardized incidence ratios (SIRs). @*Results@#SIRs and 95% confidence intervals of all cerebro-cardiovascular diseases for police officers and firefighters were 1.71 (1.66–1.76) and 1.22 (1.12–1.31), respectively, as compared with all public officers. The incidence ratios remained significantly higher compared to general and education officers. Subgroup analyses for myocardial infarction, stroke, and cardiac arrhythmia exhibited significant increases in incidence ratios among police officers and firefighters. @*Conclusion@#This study suggests that both police officers and firefighters are at high risk of cerebro-cardiovascular diseases.Therefore, medical protection measures for these occupational groups should be improved.
ABSTRACT
Background@#In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. @*Methods@#This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. @*Results@#Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. @*Conclusion@#This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.
ABSTRACT
Background@#In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. @*Methods@#This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. @*Results@#Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. @*Conclusion@#This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.
ABSTRACT
Background@#The purpose of this study is to explain the factors influencing the incurrence of catastrophic health expenditure of national health insurance households using panel data observed over a long period. @*Methods@#The study targeted 3,652 households who had no censoring during the 11-year survey period (2007–2017) and householders whose insurance type was consistently maintained as national health insurance. Generalized estimating equations were adopted to identify factors affecting the occurrence of catastrophic health expenditure at 20%, 30%, and 40% threshold levels. A subgroup analysis was conducted by categorizing groups depending on the existence of the elderly in the household. @*Results@#For the last 11 years, the incidence of catastrophic health expenditure in the households without the elderly decreased slightly at all threshold levels, but the households with the elderly seemed to be increased. At baseline, household type showed a statistically significant relationship with all other variables. The results of generalized estimating equations analyses show that household income was not significant at all threshold levels in the households without elderly. On the other hand, in the households with the elderly, the 2nd (odds ratio [OR], 1.33–2.05) and 3rd quintile groups (OR, 1.25–2.55) were more likely to have catastrophic health expenditure compared to the 1st quintile of household income group. @*Conclusion@#As the amount of health expenditures relative to the ability to pay is increasing in households with the elderly, the application of an intervention followed by consistent monitoring is needed. This study found that there were differences in influencing factors according to the presence of the elderly in the households. In particular, in households with the elderly, interesting results have been drawn regarding the occurrence of catastrophic health expenditure in the near-poor, so additional research is required.
ABSTRACT
Background@#The purpose of this study is to explain the factors influencing the incurrence of catastrophic health expenditure of national health insurance households using panel data observed over a long period. @*Methods@#The study targeted 3,652 households who had no censoring during the 11-year survey period (2007–2017) and householders whose insurance type was consistently maintained as national health insurance. Generalized estimating equations were adopted to identify factors affecting the occurrence of catastrophic health expenditure at 20%, 30%, and 40% threshold levels. A subgroup analysis was conducted by categorizing groups depending on the existence of the elderly in the household. @*Results@#For the last 11 years, the incidence of catastrophic health expenditure in the households without the elderly decreased slightly at all threshold levels, but the households with the elderly seemed to be increased. At baseline, household type showed a statistically significant relationship with all other variables. The results of generalized estimating equations analyses show that household income was not significant at all threshold levels in the households without elderly. On the other hand, in the households with the elderly, the 2nd (odds ratio [OR], 1.33–2.05) and 3rd quintile groups (OR, 1.25–2.55) were more likely to have catastrophic health expenditure compared to the 1st quintile of household income group. @*Conclusion@#As the amount of health expenditures relative to the ability to pay is increasing in households with the elderly, the application of an intervention followed by consistent monitoring is needed. This study found that there were differences in influencing factors according to the presence of the elderly in the households. In particular, in households with the elderly, interesting results have been drawn regarding the occurrence of catastrophic health expenditure in the near-poor, so additional research is required.