Factors Associated with Screening for Diabetic Retinopathy in Diabetic Patients Aged ≥ 40 Years Using the KNHANES IV

Abstract

1.08-1.89), 건강하다고 생각하는 군(OR=1.5, 95% CI:1.14-2.09)들로 분석되었다. The term 'spouse' refers to an individual who is legally married or cohabiting, 'without spouse' refers to an individual who is single, divorced, or separated; ‡ Lifetime smoker included respondents who reported that they have smoked at least 100 cigarettes in their lifetime and now smoke; § Moderate-intensity activities as that lasting 10 minutes or more and increasing heart rate slightly compared with sedentary lifestyle. Subjects were asked the following question: "Have you ever had an eye examination (or fundus examination) for screening of diabetic retinopathy within one year?" with response of "yes" and "no"; † To derive income per adult equivalent, we defined as household 'income / square root of person'; ‡ The term 'spouse' refers to an individual who is legally married or cohabiting, 'without spouse' refers to an individual who is single, divorced, or separated; § Lifetime smoker included respondents who reported that they have smoked at least 100 cigarettes in their lifetime and now smoke; ∏ Moderate-intensity activities as that lasting 10 minutes or more and increasing heart rate slightly compared with sedentary lifestyle. 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 이들 변수들과 당뇨 안 검진과의 다변량 분석 결과를 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. J Korean Ophthalmol Soc 2012;53(4):516-521

Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea

“…Meanwhile, Lim and Choi ( 2 ) analyzed Korea National Health and Nutrition Examination Survey IV results and stated that 464 of 1,257 patients underwent ophthalmological examination for diabetic retinopathy within a year, accounting for only 36.9% of patients. Therefore, the probability of opportunistic examination by ophthalmologists was presumed to be 36.9%.…”

“…In Korea, according to Lim and Choi ( 2 ), 36.9% of patients with diabetes aged > 40 yr underwent screening for diabetic retinopathy in the Korea National Health and Nutrition Examination Survey IV. This proportion was markedly lower than that in advanced countries, including 51% in the USA and 59% in the UK ( 3 4 ).…”

Current Status and Associated Factors of Annual Eye Examination Among People with Type 2 Diabetes Mellitus: Using the 7th National Health and Nutrition Examination Survey

“…Age showed inconsistent results, including no significant association with adherence rates [16], lower nonadherence rates for those aged 65 years or older [18], and higher nonadherence rates for those aged 80 years or older [15]. Additionally, gender also showed inconsistent association across studies of people with DM in Korea, including higher adherence rates in women [16], or no significant difference between men and women [15,18], while it was not a significant factor in foreign countries [8,13,14,17]. Several community-based studies of the general population have reported that the prevalence of visual impairment and blindness [19] and the use of eye examinations [20] were higher in women, as was the fundus examination rate for people with diabetic retinopathy [21].…”

“…Studies have shown that better knowledge or education about DM [8,14], in addition to sociodemographic characteristics such as older age, longer DM duration, and insurance coverage [8,17], is associated with adherence to AEEs in foreign countries. In Korea, an education level of college graduates or above and a DM duration of 5 years were found to have a positive association with AEEs, but insurance coverage was not a significant factor because of the provision of national health insurance [16,18]. Age showed inconsistent results, including no significant association with adherence rates [16], lower nonadherence rates for those aged 65 years or older [18], and higher nonadherence rates for those aged 80 years or older [15].…”

“…In Korea, an education level of college graduates or above and a DM duration of 5 years were found to have a positive association with AEEs, but insurance coverage was not a significant factor because of the provision of national health insurance [16,18]. Age showed inconsistent results, including no significant association with adherence rates [16], lower nonadherence rates for those aged 65 years or older [18], and higher nonadherence rates for those aged 80 years or older [15]. Additionally, gender also showed inconsistent association across studies of people with DM in Korea, including higher adherence rates in women [16], or no significant difference between men and women [15,18], while it was not a significant factor in foreign countries [8,13,14,17].…”