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Original Articles
Impact of Cardiovascular Disease on Health Insurance Coverage and Healthcare Use under Economic Stress: The National Health and Nutrition Examination Survey, 2003–2012
Ji Li, Hong Lai, Dong Chen, Shaoguang Chen, Shenghan Lai
Osong Public Health Res Perspect. 2019;10(3):123-136.   Published online June 30, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.3.03
  • 4,216 View
  • 47 Download
AbstractAbstract PDF
Objectives

Cardiovascular disease (CVD) has a substantial financial impact on healthcare systems in the US. This study aimed to examine the impact of CVD on health insurance coverage and health service use under economic stress as indicated by the Great Recession in the US (December 2007–June 2009).

Methods

Data of 26,483 adults aged ≥ 20 years from the 2003–2012 National Health and Nutrition Examination Survey were analyzed. There were 9,479 adults assigned to the group “before the Great Recession” (2003–2006), 5,674 adults assigned to “during the Great Recession” (2007–2008), and 11,330 adults assigned to “after the Great Recession” (2009–2012).

Results

Patients with CVD from low-income families were more likely to have health insurance during the recession (OR:1.57, 95% CI: 1.01,2.45). Those participants without CVD, who were from low-income families or < 65 years, were more likely to use the emergency room rather than primary care facilities to gain access to routine healthcare (p < 0.05). Patients with CVD from high-income families were also more likely to use the emergency room (p < 0.05). Patients with CVD but not those without CVD, who reported a high family income or were ≥ 65 years old, were less likely to use mental health services during the recession than before the recession.

Conclusion

Effective strategies need to be developed to promote primary care use among the general adult American population. In addition, use of mental health services among patients with CVD needs to be improved when financial stress occurs.

Changing Disease Trends in the Northern Gyeonggi-do Province of South Korea from 2002 to 2013: A Big Data Study Using National Health Information Database Cohort
Young Soo Kim, Dong-Hee Lee, Hiun Suk Chae, Kyungdo Han
Osong Public Health Res Perspect. 2018;9(5):248-254.   Published online October 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.5.06
  • 5,130 View
  • 75 Download
AbstractAbstract PDF
Objectives

To investigate the chronological patterns of diseases in Northern Gyeonggi-do province, South Korea, and compare these with national data.

Methods

A National Health Insurance cohort based on the National Health Information Database (NHID Cohort 2002–2013) was used to perform a retrospective, population-based study (46,605,433 of the target population, of which 1,025,340 were randomly sampled) to identify disease patterns from 2002 to 2013. Common diseases including malaria, cancer (uterine cervix, urinary bladder, colon), diabetes mellitus, psychiatric disorders, hypertension, intracranial hemorrhage, bronchitis/bronchiolitis, peptic ulcer, and end stage renal disease were evaluated.

Results

Uterine cervix cancer, urinary bladder cancer and colon cancer had the greatest rate of increase in Northern Gyeonggi-do province compared with the rest of the country, but by 2013 the incidence of these cancers had dropped dramatically. Acute myocardial infarction and end stage renal disease also increased over the study period. Psychiatric disorders, diabetes mellitus, hypertension and peptic ulcers showed a gradual increase over time. No obvious differences were found for intracranial hemorrhage or bronchitis/bronchiolitis between the Northern Gyeonggi-do province and the remaining South Korean provinces. Malaria showed a unique time trend, only observed in the Northern Gyeonggi province, peaking in 2004, 2007 and 2009 to 2010.

Conclusion

This study showed that the Northern Gyeonggi-do province population had a different disease profile over time, compared with collated data for the remaining provinces in South Korea. “Big data” studies using the National Health Insurance cohort database can provide insight into the healthcare environment for healthcare providers, stakeholders and policymakers.

Short Communication
What Makes Vietnamese (Not) Attend Periodic General Health Examinations? A 2016 Cross-sectional Study
Quan-Hoang Vuong, Quang-Hoi Vu, Thu-Trang Vuong
Osong Public Health Res Perspect. 2017;8(2):147-154.   Published online April 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.2.07
  • 4,310 View
  • 26 Download
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Objectives

General health examinations (GHE) have become an increasingly common measure for preventive medicine in Vietnam. However, little is known about the factors among Viet-namese people who attend or miss GHE. Budget or time constraints remain to be evaluated for better-informed policy making. This study investigates factors affecting behaviors in attending periodic GHE. The main objectives are as follows: (1) to explore empirical relationships between influencing factors and periodic GHE frequencies, and (2) to predict the probabilities of attending GHE under associated conditions.

Methods

The study used a 2,068-observational dataset, obtained from a Vietnamese survey in 2016. The analysis was then performed using the methods of baseline-category logits for establishing relationships between predictor and response variables.

Results

Significant relationships were found among the expenditure and time consumption, health priority and sensitivity to health data, insurance status, and frequency of GHE, with most p-values = 0.01.

Conclusion

Generally, people attended the GHE when they had the resources and health priorities (72.7% probability). Expenditure and time remain key obstacles to the periodic GHE. Health priority and health data are important in improving rates for GHEs. Health insurance should play a positive role in promoting the GHE.

Citations

Citations to this article as recorded by  
  • Multiple Chronic Conditions and Disability among Vietnamese Older Adults: Results from the Vietnamese Aging and Care Survey (VACS)
    Christina E. Miyawaki, Joshua M. Garcia, Kim N. Nguyen, Van Ta Park, Kyriakos S. Markides
    Journal of Racial and Ethnic Health Disparities.2023;[Epub]     CrossRef
  • Sex Differences and Psychological Factors Associated with General Health Examinations Participation: Results from a Vietnamese Cross-Section Dataset
    Quan-Hoang Vuong, Kien-Cuong Nghiem, Viet-Phuong La, Thu-Trang Vuong, Hong-Kong Nguyen, Manh-Toan Ho, Kien Tran, Thu-Hong Khuat, Manh-Tung Ho
    Sustainability.2019; 11(2): 514.     CrossRef
  • Health Care Payments in Vietnam: Patients’ Quagmire of Caring for Health versus Economic Destitution
    Andre Pekerti, Quan-Hoang Vuong, Tung Ho, Thu-Trang Vuong
    International Journal of Environmental Research an.2017; 14(10): 1118.     CrossRef
  • Psychological and Socio-Economic Factors Affecting Social Sustainability through Impacts on Perceived Health Care Quality and Public Health: The Case of Vietnam
    Quan-Hoang Vuong, Thu-Trang Vuong, Tung Ho, Ha Nguyen
    Sustainability.2017; 9(8): 1456.     CrossRef

PHRP : Osong Public Health and Research Perspectives