40세 이상 당뇨환자에서 당뇨 안 검진과 관련된 요인 분석: 제4기 국민건강 영양 조사자료
Factors Associated with Screening for Diabetic Retinopathy in Diabetic Patients Aged ≥ 40 Years Using the KNHANES IV
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목적: 당뇨 안 검진과 관련된 사회인구통계학적, 건강 상태와 관련된 요인을 밝히고자 하였다. 대상과 방법: 1,257명의 제4기 국민건강영양조사 중 40세 이상의 당뇨병 환자에 대하여 다변량 로지스틱 회귀분석으로 당뇨 안 검진과관련된 요인을 분석하였다. 결과: 40세 이상 당뇨 환자 1,257명 중 당뇨 안 검진을 받은 환자의 수는 464명(36.9%)이었다. 65세 이상(adjusted odds ratios [aOR]=0.7, 95% CI: 0.51-0.85), 대학 이상의 고학력자들(aOR=0.5, 95% CI: 0.32-0.74)에서 당뇨 안 검진 비수검자의 비율이 적었고,시골에 거주할수록(aOR=1.7, 95% CI: 1.32-2.24), 주관적 건강상태에서 건강하다고 생각할수록(aOR=1 [기준: 건강하지 않음],aOR=1.7 [보통], 95% CI: 1.25-2.23, aOR=1.8 [건강함], 95% CI: 1.30-2.44) 당뇨 안 검진 비수검자의 비율이 높았다. 결론: 당뇨 안 검진 취약계층, 즉 고령군보다는 경제 활동군인 40세에서 64세 사이군, 저 학력군, 시골거주군, 주관적인 건강이 좋다고생각하는 군에 대한 사회적 관심 및 계도가 필요하다.
Abstract
Purpose: To identify factors associated with care of diabetic retinopathy. Methods: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. This survey included 1, 257 people aged 40 years and older with a history of diabetic mellitus who answered questions, “Within one year, have you ever received eye examination (fundus photography) for screening diabetic retinopathy?” Factors that affect care of diabetic retinopathy were identified using multiple logistic regression analysis. Results: Among the 1,257 people aged 40 years and older, 464 (36.9%) received screening for diabetic retinopathy. People aged 65 years and older (aOR = 0.7, 95% CI: 0.51-0.85) with university education (aOR = 0.5, 95% CI: 0.32-0.74)were more likely to undergo screening for diabetic retinopathy compared to those in the reference category (40-64 years old and those who had elementary school or lower education). People living in rural areas were less likely to undergo screening for diabetic retinopathy compared to those living in urban areas (aOR = 1.7, 95% CI: 1.32-2.24). Diabetic retinopathy screening was also associated with self-reported health status (ref: unhealthy [aOR = 1], fair [aOR = 1.7, 95% CI:1.25-2.23], and healthy [aOR = 1.8, 95% CI: 1.30-2.44]). Conclusions: To increase nationwide screening rates for diabetic retinopathy, more attention should be given to underserved groups, particularly people aged between 40 and 64 years, those with a low education level, those living in rural areas, and those with a positive attitude toward self-reported health status. These issues highlight the need for a new emphasis in health education and public health policies aimed towards these underserved groups.
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