본문 바로가기
KERD
논문KCI 등재

Effects of adults’ health behaviors and combinations thereof on health outcomes: an analysis using National Health Insurance Service of Korea cohort data

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

초록

develOBJECTIVES: The purpose of this study was to estimate the effects of health-risk behaviors, alone and in combination, on health outcomes. METHODS: This study used sample cohort data provided by the National Health Insurance Service focusing on the use of hospital services, direct medical expenses, length of stay, and re-entry rate according to health-risk behaviors. A frequency analysis and the chi-square test were used to investigate associations between the demographic characteristics of study subjects and their health-risk behaviors. The strength of the association of each factor was calculated as the odds ratio in a crossover analysis. RESULTS: Obesity had the largest effect, especially in combination with smoking and drinking. In particular, significant associations were shown with the duration of hospitalization and direct medical expenses. After adjustment for sex, age, economic status, and pre-existing medical conditions, the duration of hospitalization was 7.37 times longer and that of medical expenses was 5.18 times higher in the obese group relative to the non-obese group. Drinking showed a statistically significant association with the number of days of hospitalization. After adjusting for the control variables, the number of hospital days was 1.24 longer in the drinking group than in the non-drinking group. CONCLUSIONS: An analysis of combinations of health risk factors showed obesity had the largest effect.

Abstract

develOBJECTIVES: The purpose of this study was to estimate the effects of health-risk behaviors, alone and in combination, on health outcomes. METHODS: This study used sample cohort data provided by the National Health Insurance Service focusing on the use of hospital services, direct medical expenses, length of stay, and re-entry rate according to health-risk behaviors. A frequency analysis and the chi-square test were used to investigate associations between the demographic characteristics of study subjects and their health-risk behaviors. The strength of the association of each factor was calculated as the odds ratio in a crossover analysis. RESULTS: Obesity had the largest effect, especially in combination with smoking and drinking. In particular, significant associations were shown with the duration of hospitalization and direct medical expenses. After adjustment for sex, age, economic status, and pre-existing medical conditions, the duration of hospitalization was 7.37 times longer and that of medical expenses was 5.18 times higher in the obese group relative to the non-obese group. Drinking showed a statistically significant association with the number of days of hospitalization. After adjusting for the control variables, the number of hospital days was 1.24 longer in the drinking group than in the non-drinking group. CONCLUSIONS: An analysis of combinations of health risk factors showed obesity had the largest effect.

참고문헌 (32)

  1. Imposing health risk factor levy for securing health insurance fund, "Lee SM", National Health Insurance Service, ~, pp.Report 2012-08 (2014)
  2. A study on the effective chronic disease management, "Jung YH", Korea Institute for Health and Social Affairs, 41~42 (2013)
  3. Socioeconomic, behavioral, nutritional, and biological determinants of mortality in South Korea: analysis of Korea National Health and Nutrition Examination Survey (K-NHANES) linked data, "Kim HR", Korea Institute for Health and Social Affairs, 143~144 (2014)
  4. "Deaths from NCDs: situation and trends"[URL]
  5. Cawley J, "Handbook of health economics. Volume 2", pp.95~199 (2012), Elsevier
  6. Grossman M, "Handbook of health economics. Vol. 1", pp.347~408 (2000), Elsevier
  7. Sturm R, "The effects of obesity, smoking, and drinking on medical problems and costs", Health Aff(Millwood), 21, pp.245~253 (2002)
  8. Bertakis KD, "The influence of obesity, alcohol abuse, and smoking on utilization of health care services", Fam Med, 38, pp.427~434 (2006)
  9. Vals K, "Alcohol consumption, smoking and overweight as a burden for health care services utilization : a cross-sectional study in Estonia", BMC Public Health, 13, pp.772~ (2013)
  10. Noble N, "Which modifiable health risk behaviours are related? A systematic review of the clustering of smoking, nutrition, alcohol and physical activity(‘SNAP’)health risk factors", Prev Med, 81, pp.16~41 (2015)
  11. Poortinga W, "The prevalence and clustering of four major lifestyle risk factors in an English adult population", Prev Med, 44, pp.124~128 (2007)
  12. Chiolero A, "Clustering of risk behaviors with cigarette consumption : a population-based survey", Prev Med, 42, pp.348~353 (2006)
  13. Benjamin EJ, "Heart disease and stroke statistics-2017 update: a report from the American Heart Association", Circulation, 135, pp.e146~e603 (2017)
  14. Lin TF, "Modifiable health risk factors and medical expenditures-the case of Taiwan", Soc Sci Med, 67, pp.1727~1736 (2008)
  15. Musich S, "The association between health risk status and health care costs among the membership of an Australian health plan", Health Promot Int, 18, pp.57~65 (2003)
  16. 강은정, "흡연, 음주, 신체활동을 사용한 한국 성인의 건강행태 군집의 분류", 보건사회연구, 27(2), pp.44~66 (2007), 한국보건사회연구원[DOI]
  17. 이예지, "성인의 만성질환 관련 건강위험행태요인 군집현상 분석", 보건교육건강증진학회지, 34(3), pp.21~31 (2017), 한국보건교육건강증진학회[DOI]
  18. 최성은, "흡연자의 의료비 지출과 흡연이 의료비 지출에 미치는 효과", 재정학연구, 9(2), pp.1~21 (2016), 한국재정학회
  19. Slater CH, "What is outcomes research and what can it tell us?", Eval Health Prof, 20, pp.243~264 (1997)
  20. Mant J, "Detecting differences in quality of care : the sensitivity of measures of process and outcome in treating acute myocardial infarction", BMJ, 311, pp.793~796 (1995)
  21. Lynch WD, "The association between health risks and medical expenditures in a Japanese corporation", Am J Health Promot, 19(3 Suppl), pp.238~248 (2005)
  22. Park EJ, "The 3rd Korea Medical Panel Academy", pp.177~190 (2011), Korea Institute for Health and Social Affairs
  23. 홍성훈, "금연과 비만과의 관계에 대한 실증분석", 보건경제와 정책연구, 17(1), pp.127~144 (2011), 한국보건경제정책학회
  24. Rice DP, "Alcohol drinking patterns and medical care use in an HMO setting", J Behav Health Serv Res, 27, pp.3~16 (2000)
  25. Nakamura K, "Alcohol consumption, hospitalization and medical expenditure : a large epidemiological study on the medical insurance system in Japan", Alcohol Alcohol, 50, pp.236~243 (2015)
  26. 차지은, "당뇨 환자의 운동실천에 따른 건강행태, 의료이용 및 의료비용 비교", 지역사회간호학회지, 26(1), pp.31~41 (2015), 한국지역사회간호학회[DOI]
  27. Goetzel RZ, "The relationship between modifiable health risks and health care expenditures. An analysis of the multi-employer HERO health risk and cost database", J Occup Environ Med, 40, pp.843~854 (1998)
  28. Zwolinsky S, "Prevalence, co-occurrence and clustering of lifestyle risk factors among UK men", J Mens Health, 12, pp.15~24 (2017)
  29. Satre DD, "Alcohol consumption, medical conditions, and health behavior in older adults", Am J Health Behav, 31, pp.238~248 (2007)
  30. Ha S, "Clustering of four major lifestyle risk factors among Korean adults with metabolic syndrome", PLoS One, 12, pp.e0174567~ (2017)
  31. Morris LJ, "Concurrent lifestyle risk factors : clusters and determinants in an Australian sample", Prev Med, 84, pp.1~5 (2016)
  32. Lee J, "Cohort profile: the National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea", Int J Epidemiol, 46, pp.e15~ (2017)

관련 논문AI추천

이 간행물의 다른 논문 (50건)