Korean J Fam Med.  2020 Mar;41(2):119-125. 10.4082/kjfm.18.0130.

Comparison of Health Status in Primary Care Underserved Area Residents and the General Population in Korea

Affiliations
  • 1Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
  • 2Institute for Public Health and Medical Service, Seoul National University Hospital, Seoul, Korea
  • 3Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea

Abstract

Background
This study compared chronic diseases and health-related quality of life (HRQoL) in between primary care underserved areas residents and the general population.
Methods
Underserved areas were identified according to accessibility and the time relevance index for primary care. Overall, 279 participants aged ≥60 years from four counties enrolled voluntarily. A total of 1,873 individuals were assigned in the control group using the Korea National Health and Nutrition Examination Survey database. We assessed the differences in prevalence, awareness, and control of hypertension and diabetes and HRQoL using both subjective health status and the Korean version of the EuroQol-5D (EQ-5D) questionnaire using multivariate logistic regression analysis between the two groups.
Results
For hypertension, prevalence did not differ significantly between the two groups, whereas awareness and control were lower in the underserved areas than that in the general population; the adjusted odds ratios (95% confidence interval) were 0.40 (0.25–0.64) and 0.27 (0.18–0.41), respectively. For diabetes, differences in prevalence, awareness, and control were statistically insignificant. The proportion reporting poor subjective health status and problems in four EQ-5D indexes (ability to exercise, daily activities, pain/discomfort, anxiety/depression) was higher in the underserved areas, which also had a lower EQ-5D index, than that in the general population.
Conclusion
Primary care underserved area residents were underdiagnosed and under-controlled for hypertension and reported poorer subjective health and HRQoL compared to the general population. Primary care is the attributable factor to awareness and control of chronic diseases and subjective health and QoL in communities.

Keyword

Medically Underserved Area; Health Status Disparities; Hypertension; Diabetes Mellitus; Quality of Life; Korea
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