|
KMID : 1039620150050030289
|
|
Korean Journal of Family Practice
2015 Volume.5 No. 3 p.289 ~ p.295
|
|
|
Possession of a Medical Doctor as a Usual Source of Care in Patients with Diabetes and Its Associated Socioeconomic Factors in South Korea
|
|
Min Dong-Ki
Choi Sung-Ah
Choi Young-Ho
Lee Jae-Ho
|
|
|
Abstract
|
|
|
Background : As non-infectious diseases become prevalent worldwide, leading nations are reinforcing primary care for efficient control of these diseases. This study aims to identify status of patients with diabetes, one of the representative non-infectious diseases, who have a doctor as a usual source of care, and to analyze relevant socio-demographic factors as a basis for health and medical policy-making for extending primary care.
Methods : This study included 1,052 patients aged 18 or over with a history of outpatient treatment for diabetes out of all participants in the Korea Health Panel survey in 2012 (n=15,872); and compared their distribution by demographic variables (age, gender, marital status, education level, income level, and health insurance coverage), subjective self-perception of health, health behavior-related variable (body mass index, smoking, alcohol consumption, and exercise) and medical institution type. Further analysis was performed on factors associated with having a family doctor through logistic regression analysis with a control of demographic variables (model 1), subjective health awareness (model 2), and health behavior factors (model 3).
Results : Only 37.6% of those who were treated as outpatient for diabetes in the last one year were found to have a family doctor. A statistically significant difference was witnessed in different age groups (P=0.020); the 18-49 age group had the lowest percentage of people with a family doctor (26.9%), whereas the 65-and-over age group had the highest percentage of people with a family doctor (39.7%). A statistically significant difference was also noted in income level (P=0.030); the 4th quartile exhibited the lowest level with 33.3% while the 1st quartile marked the highest with 43.6%. The possession variance by type of usual source of care showed that 69.8% of public medical institution users, 67.1% of hospital users, and 0.8% of individuals with no usual source of care had a family doctor (P<0.001). In terms of factors associated with possession of a family doctor, the higher the age group and the lower the income level, the higher the odds ratio was in diabetic patients aged 18 and over; the 65-and-over age group had 1.83 times (95% confidence interval [CI], 1.09 to 3.06) the odds of having a family doctor compared to the under 50 age group. The 1st quintile with the lowest level of income had the highest likelihood of possessing a family doctor, and the 2nd quintile had 0.66 times (95% CI, 0.46 to 0.95) the odds of having one compared to the 1st quintile. However, despite the fact that a greater odds ratio was found in females compared to males and the group with higher education level than the lower, no consistent result was obtained across regression models.
Conclusion : It is difficult to anticipate sustainable health management as only a low percentage of diabetic patients in Korea have a doctor as a usual source of care. This study suggests that, when conducting a pilot primary care program to improve service quality for diabetics, the higher-age or lower-income groups should be primarily targeted to increase the chance of success.
|
|
|
KEYWORD
|
|
|
Primary Health Care, Demographic Factor, Diabetes Mellitus, Socio-Demographic Factor
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|
|