The association between socio-economic status and healthcare utilization and health behavior by the progressive stage of metabolic syndrome
The prevalence of metabolic syndrome, required high level of preventive care, has been rapidly increased in Korea. Therefore, the importance of comprehensive assessing the health utilization in the group of metabolic syndrome has been also emphasized in the aspects of effective resources distribution in community. The objectives of this research are to classify the metabolic syndrome into several groups based on the severities of clinical symptoms (MS-0, MS-1, MS-2, MS-3). In addition, the differences in health care utilization, cost and health behaviors by socio-economic statusis also investigated in each group. We analyzed a total of 15,617 adult subject (ages ≥20) who participated in the Korean National Health and Nutrition Examination Survey Ⅳ (2007,2008,2009). We distinguished metabolic syndrome groups according to progressive stage of metabolic syndrome. Socioeconomic status was measured by income level that ranges from 1(lowest) to 4(highest). We conducted ANOVA to investigate the difference of cost, utilization and health behavior (exercise score & eating low salt food) by income level in two groups, and used univariate general linear model(GLM) to assess whether interaction between income and having MS-related disease has an effects on dependent variables. There was no significant difference of average outpatient cost by income level in other groups, but differences in subject with MS-1 significantly existed, especially between highest income group(￦31,992) and the other groups(1Q: ￦6,438 2Q: ￦4,720 3Q: ￦8,578). In health behavior, There were significant differences of exercise score and eating low-salt food by income level in all group except for MS-3. Interaction term between income level which means whether they are highest income group or not and having MS-related diseases was significantly effective on outpatient cost(P<0.01). In conclusion, various differences were found in health care utilization as well as cost and health behaviors according to their socio-economic status especially in the patients with mild symptoms(MS-1). Low and middle income patients take relatively low level of medical care services in the group of metabolic syndrome with mild symptoms(MS-1) who need intensive preventive care, and high income group tends to have appropriate health behavior relatively.
대사증후군, 대사증후군 관련 질병, 불형평성, 상호작용효과, Metabolic syndrome, Metabolic syndrome-related disease, Health care service, Disparity, Moderating effect
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