The effects of socioeconomic and geographic factors on chronic phase long-term survival after stroke in South Korea
- Authors
- Park, Dougho; Lee, Su Yun; Jeong, Eunhwan; Hong, Daeyoung; Kim, Mun-Chul; Choi, Jun Hwa; Shin, Eun Kyong; Son, Kang Ju; Kim, Hyoung Seop
- Issue Date
- 14-3월-2022
- Publisher
- NATURE PORTFOLIO
- Citation
- SCIENTIFIC REPORTS, v.12, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- SCIENTIFIC REPORTS
- Volume
- 12
- Number
- 1
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/140091
- DOI
- 10.1038/s41598-022-08025-2
- ISSN
- 2045-2322
- Abstract
- The stroke incidence has increased rapidly in South Korea, calling for a national-wide system for long-term stroke management. We investigated the effects of socioeconomic status (SES) and geographic factors on chronic phase survival after stroke. We retrospectively enrolled 6994 patients who experienced a stroke event in 2009 from the Korean National Health Insurance database. We followed them up from 24 to 120 months after stroke onset. The endpoint was all-cause mortality. We defined SES using a medical-aid group and four groups divided by health insurance premium quartiles. Geographic factors were defined using Model 1 (capital, metropolitan, city, and county) and Model 2 (with or without university hospitals). The higher the insurance premium, the higher the survival rate tended to be (P < 0.001). The patient survival rate was highest in the capital city and lowest at the county level (P < 0.001). Regions with a university hospital(s) showed a higher survival rate (P = 0.006). Cox regression revealed that the medical-aid group was identified as an independent risk factor for chronic phase mortality. Further, NHIP level had a more significant effect than geographic factors on chronic stroke mortality. From these results, long-term nationwide efforts to reduce inter-regional as well as SES discrepancies affecting stroke management are needed.
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Collections - College of Liberal Arts > Department of Sociology > 1. Journal Articles
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