Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Factors associated with Experience of Diagnosis and Utilization of Chronic Diseases among Korean Elderly : Focus on Comparing between Urban and Rural Elderly

한국 노인의 만성질환 진단경험 및 의료이용에 관련된 요인 : 도시와 농촌 간 비교를 중심으로

  • Lee, Min Ji (Department of Medicine, College of Medicine, Konyang University) ;
  • Kown, Dong Hyun (Department of Medicine, College of Medicine, Konyang University) ;
  • Kim, Yong Yook (Department of Medicine, College of Medicine, Konyang University) ;
  • Kim, Jae Han (Department of Medicine, College of Medicine, Konyang University) ;
  • Moon, Sung Jun (Department of Medicine, College of Medicine, Konyang University) ;
  • Park, Keon Woo (Department of Medicine, College of Medicine, Konyang University) ;
  • Park, Il Woo (Department of Medicine, College of Medicine, Konyang University) ;
  • Park, Jun Young (Department of Medicine, College of Medicine, Konyang University) ;
  • Baek, Na Yeon (Department of Medicine, College of Medicine, Konyang University) ;
  • Son, Gi Seok (Department of Medicine, College of Medicine, Konyang University) ;
  • Ahn, So Yeon (Department of Medicine, College of Medicine, Konyang University) ;
  • Yeo, In Uk (Department of Medicine, College of Medicine, Konyang University) ;
  • Woo, Sang Ah (Department of Medicine, College of Medicine, Konyang University) ;
  • Yoo, Sung Yun (Department of Medicine, College of Medicine, Konyang University) ;
  • Lee, Gi Beop (Department of Medicine, College of Medicine, Konyang University) ;
  • Lim, Soo Beom (Department of Medicine, College of Medicine, Konyang University) ;
  • Jang, Soo Hyun (Department of Medicine, College of Medicine, Konyang University) ;
  • Jang, In-Deok (Department of Medicine, College of Medicine, Konyang University) ;
  • Jeon, Jeong-U (Department of Medicine, College of Medicine, Konyang University) ;
  • Jeong, Su Jin (Department of Medicine, College of Medicine, Konyang University) ;
  • Jung, Yeon Ju (Department of Medicine, College of Medicine, Konyang University) ;
  • Cho, Seong Geon (Department of Medicine, College of Medicine, Konyang University) ;
  • Cha, Jeong Sik (Department of Medicine, College of Medicine, Konyang University) ;
  • Hwang, Ki Seok (Department of Medicine, College of Medicine, Konyang University) ;
  • Lee, Tae-Jun (Department of Preventive Medicine and Public Health, College of Medicine, Konyang University) ;
  • Lee, Moo-Sik (Department of Preventive Medicine and Public Health, College of Medicine, Konyang University)
  • 이민지 (건양대학교 의과대학 의학과) ;
  • 권동현 (건양대학교 의과대학 의학과) ;
  • 김용욱 (건양대학교 의과대학 의학과) ;
  • 김재한 (건양대학교 의과대학 의학과) ;
  • 문성준 (건양대학교 의과대학 의학과) ;
  • 박건우 (건양대학교 의과대학 의학과) ;
  • 박일우 (건양대학교 의과대학 의학과) ;
  • 박준영 (건양대학교 의과대학 의학과) ;
  • 백나연 (건양대학교 의과대학 의학과) ;
  • 손기석 (건양대학교 의과대학 의학과) ;
  • 안소연 (건양대학교 의과대학 의학과) ;
  • 여인욱 (건양대학교 의과대학 의학과) ;
  • 우상아 (건양대학교 의과대학 의학과) ;
  • 유성윤 (건양대학교 의과대학 의학과) ;
  • 이기법 (건양대학교 의과대학 의학과) ;
  • 임수범 (건양대학교 의과대학 의학과) ;
  • 장수현 (건양대학교 의과대학 의학과) ;
  • 장인덕 (건양대학교 의과대학 의학과) ;
  • 전정우 (건양대학교 의과대학 의학과) ;
  • 정수진 (건양대학교 의과대학 의학과) ;
  • 정연주 (건양대학교 의과대학 의학과) ;
  • 조성건 (건양대학교 의과대학 의학과) ;
  • 차정식 (건양대학교 의과대학 의학과) ;
  • 황기석 (건양대학교 의과대학 의학과) ;
  • 이태준 (건양대학교 의과대학 예방의학교실) ;
  • 이무식 (건양대학교 의과대학 예방의학교실)
  • Received : 2019.07.09
  • Accepted : 2019.11.17
  • Published : 2019.12.31
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Abstract

Objectives: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. Methods: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. Results: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092-1.183) for diagnosis of diabetes, 1.278 (1.278-1.386) for diagnosis of dyslipidemia, 0.940 (0.904-0.977) for diagnosis of arthritis, 0.785(0.736-0.837) for treatment of arthritis, 1.159 (1.116-1.203) for diagnosis of cataracts, and 1.285(1.200-1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p <0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p <0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. Conclusion: Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

이 연구는 도시와 농촌에 거주하는 노인인구의 일반적 특성변수, 건강행태와 만성질병 진단 및 치료경험 등의 차이와 그 관련요인을 비교하고자 하였다. 이 연구는 질병관리본부의 2017년 지역사회건강조사 원시자료를 활용하였다. 연구 대상은 만 65세 이상 노인으로 총 67,835명의 자료를 이용하였다. 카이제곱검정과 단변량 및 다변량로지스틱회귀분석 등을 이용하여 비교분석하였다. 분석결과, 도시 농촌 간의 건강행태, 진단 경험과 치료 경험 등에서 차이가 있는 것으로 확인되었다. 특히, 로지스틱회귀분석 결과, 도시 노인에 비해 농촌 노인에서 당뇨 진단 경험이 1.136배 (1.092-1.183), 이상지질혈증 진단 경험 1.278배(1.278-1.386), 백내장 진단 경험 1.159배(1.116-1.203), 백내장 치료 경험 1.285(1.200-1.375)로 높았고, 관절염 진단 경험은 0.940배 (0.904-0.977) 낮았다. 백내장 치료 경험에서는 농촌 노인이 1.285배(1.200-1.375) 높았으며, 관절염 치료 경험은 0.785배(0.736-0.837) 낮았다. 만성질환 진단 및 치료 경험에는 각 질환별로 다양한 변수들이 기여변수로 도출되었는데 특히, 만성질환 진단 경험에서는 고혈압 진단 경험을 제외한 당뇨병 진단 경험, 관절염 진단 경험, 백내장 진단 경험 및 이상지질혈증 진단 경험에서 도시 농촌 지역변수가 통계적으로 유의의한 차이가 있었다(p<0.01). 치료 경험에서는 관절염과 백내장 치료 경험에서 도시 농촌 지역변수가 통계적으로 유의의한 차이가 있었으나(p<0.01) 기타 고혈압, 당뇨병, 이상지질혈증 등의 치료 경험은 유의한 차이를 보이지 않았다. 따라서 도시 농촌 간의 노인 만성질환의 관련요인을 반영하여 진단과 치료 경험에 차이가 있는 질환에 대한 전략적인 보건관리 사업의 추진이 필요해 보인다. 추후 각 만성질환별로 도시와 농촌의 지역 차이와 이환 및 예방관리 등 차이와 그 관련요인에 대한 추가적인 연구가 필요해 보인다.

Keywords

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