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KMID : 0387320210310010114
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Korean Journal of Health Policy and Administration
2021 Volume.31 No. 1 p.114 ~ p.124
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Interaction Effects between Individual Socioeconomic Status and Regional Deprivation on Onset of Diabetes Complication and Diabetes-Related Hospitalization among Type 2 Diabetes Patients: National Health Insurance Cohort Sample Data from 2002 to 2013
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Jang Ji-Eun
Ju Yeong-Jun
Lee Doo-Woong
Lee Sang-Ah
Oh So-Yeon
Choi Dong-Woo
Lee Hyeon-Ji
Shin Jae-Yong
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Abstract
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Background: In this study, we aimed to investigate the interaction effects of individual socioeconomic status and regional deprivationon the onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients.
Methods: Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 50,954patients newly diagnosed with type 2 diabetes from 2004 to 2012 and aged 30 years or above were included. We classified patientsinto six groups according to individual income level and neighborhood deprivation: ‘high in advantaged,’ ‘high in disadvantaged,’‘middle in advantaged,’ ‘middle in disadvantaged,’ ‘low in advantaged,’ and ‘low in disadvantaged.’ We calculated hazard ratios (HR)of onset of diabetes complication and diabetes-related hospitalization using the Cox proportional hazard model, with the referencegroup as diabetes patients with high income in advantaged regions.
Results: In terms of the interaction effects of individual income level and regional socioeconomic level, even with the same lowindividual income level, the group with a high regional socioeconomic level (low in advantaged) showed low HRs for the onset ofdiabetes complication (HR, 1.04; 95% confidence interval [CI], 1.00?1.08) compared to the ‘low in disadvantaged’ group (HR, 1.10;95% CI, 1.05?1.16). In addition, the ‘high in advantaged’ group showed slightly higher HRs for the onset of diabetes complication (HR,1.06; 95% CI, 1.00?1.11) compared to the ‘low in advantaged’ and it appeared to be associated with slight mitigation of the risk ofdiabetes complication. For the low-income level, the patients in disadvantaged regions showed the highest HRs for diabetes-relatedhospitalization (HR, 1.29; 95% CI, 1.19?1.41) compared to the other groups.
Conclusion: Although we need to perform further investigations to reveal the mechanisms that led to our results, interaction effectsindividual socioeconomic status and regional deprivation might be associated with on onset of diabetes complications anddiabetes-related hospitalization among type 2 diabetes patients.
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KEYWORD
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Diabetes mellitus, Diabetes complications, Regional deprivation, Diabetes-related hospitalization
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