Health care utilization by people with disabilities: A longitudinal analysis of the Korea Welfare Panel Study (KoWePS)

Jeon, Boyoung; Kwon, Soonman; Kim, Hongsoo

doi:10.1016/j.dhjo.2015.01.001

Cited by 45 publications

(37 citation statements)

References 38 publications

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“…These results are similar to those from national health surveys that observed association between functional limitation and increased number of doctor visits or hospitalizations in different countries such as United States 1 , China 2 , South Korea 16 , and Taiwan 3 . The main explanation for the increased use of health services by older adults with functional limitations lies in the higher prevalence of chronic diseases and comorbidities (and the risk of complications related to them), which, in turn, lead to the increased use of medications 1 , 2 , 17 .…”

Section: Discussionsupporting

confidence: 89%

Use of health services by Brazilian older adults with and without functional limitation

et al. 2017

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OBJECTIVE To analyze the use of health services and the quality of medical care received by Brazilian older adults with and without functional limitation.METHODS The main analyses were based on a national sample representing 23,815 participants of the National Survey on Health (PNS) aged 60 years or older. Functional limitation was defined by the difficulty to perform at least one out of ten basic or instrumental activities of daily living. Potential confounding variables included predisposing and enabling factors of the use of health services.RESULTS The prevalence of functional limitation was 30.1% (95%CI 29.2–31.4). The number of doctor visits and hospitalizations in the past 12 months showed statistically significant associations with functional limitation, both for users of the public system (OR = 2.48 [95%CI 2.13–2.88] for three or more doctor visits and OR = 2.58 [95%CI 2.15–3.09] for one or more hospitalizations) and of the private system (OR = 2.56 [95%CI 1.50–4.36] and OR = 2.22 [95%CI 1.64–3.00], respectively). The propensity to use basic health units was higher among users of the private system with functional limitations (OR = 2.01 [95%CI 1.12–3.59]). Only two out of seven indicators of the quality of medical care received were associated with functional limitation, in the perception of users of public and private systems. The public system users with functional limitations did worse evaluation of the freedom for choosing the doctor and waiting time for an appointment, when compared with users of the same system without these limitations (OR = 0.81 [95%CI 0.67–0.99] and OR = 0.76 [95%CI 0.62–0.93], respectively).CONCLUSIONS Older adults with functional limitations use more health services in comparison with those without such limitations. The magnitude of the association between functional limitation and number of doctor visits and hospitalizations was similar in the public and private health systems.

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Section: Discussionsupporting

confidence: 89%

Use of health services by Brazilian older adults with and without functional limitation

et al. 2017

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“…In the South Asia region, studies from India showed that the prevalence of non-communicable diseases (NCDs) such as diabetes and hypertension were significantly higher among PWD [ 14 , 15 ]. Similar findings were reported from other parts of Asia (Korea) too [ 10 ]. Physical impairments constitute a high proportion of PWD and with a sedentary lifestyle; risk of NCDs among these population subgroups will be high.…”

Section: Health Status Of People With Disabilitysupporting

confidence: 91%

“…They have a heightened risk of co-morbid conditions, especially non-communicable diseases and have more need of a counselling interface compared to those without a disability. Studies from South Asia and other LMICs show that the burden of poor health is accompanied by longer hospital stay [ 10 , 18 ] repeated hospitalization [ 9 , 13 , 14 ], and need for medication [ 14 ]. In Bangladesh, 85% PWD with physical impairments reported suffering from a general illness in a six-month recall period [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…Globally, irrespective of the economic development of a country, a significant proportion of the billion PWD have poorer health outcomes than those without disability [ 1 ]. Studies from the high as well as the low- and middle-income settings strongly endorse this observation [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The WHO Report also emphasizes that part of the problem with the poorer health outcomes also rests with the barriers to access to health care services, which discriminate against PWD [ 1 ].…”

Section: Health Concerns Of People With Disabilitymentioning

confidence: 94%

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Challenges in Accessing Health Care for People with Disability in the South Asian Context: A Review

Murthy

2018

IJERPH

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South Asia is a unique geopolitical region covering 3.4% of the world’s surface area and supporting 25% of the world’s population (1.75 billion). Available evidence from South Asia shows variable estimates of the magnitude of disability. The projected magnitude depends on whether an impairment focus is highlighted (approximately 1.6–2.1%) or functionality is given precedence (3.6–15.6%). People with disability (PWD) face significant challenges to accessing health care in the region. Studies show that adults with disability reported a four times higher incidence of a serious health problem in a year’s recall period. Evidence shows a significantly higher rate (17.8%) of hospitalization among PWD compared to others (5%). Chronic conditions like diabetes were also significantly higher. Women with disability had significantly more concerns on reproductive health issues. Studies from the South Asia region reveal that not only did PWD have a higher load of adverse health outcomes but they also faced significantly more barriers in accessing health services.

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“…The severity of the disability is determined by the specialist physician according to government guidelines and predefined criteria based on the functional losses and clinical impairment presented by the patient, with severity classified into six levels ( Supplementary Table 2). [11][12][13] For our analyses, disability types were reclassified as (1) physical impairment (limb disability), (2) communication impairment (visual, auditory, or linguistic disability), (3) mental impairment (brain, intellectual, autistic, or mental disability), (4) cardiopulmonary impairment (heart or lung disability), and (5) other impairment. We also dichotomized levels of severity into severe (grades 1-3) and mild (grades 4-6), according to government criteria.…”

Section: Study Setting and Data Sourcementioning

confidence: 99%

Disparities in the Diagnosis and Treatment of Lung Cancer among People with Disabilities

Shin

Cho

Noh

et al. 2019

Journal of Thoracic Oncology

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Introduction: Potential disparities in the diagnosis, treatment, and survival of patients with lung cancer with and without disabilities have rarely been investigated. Methods:We conducted a retrospective cohort study with a data set linking the Korean National Health Service database, disability registration data, and Korean Central Cancer Registry data. A total of 13,591 people with disabilities in whom lung cancer had been diagnosed and 43,809 age-and sex-matched control subjects in whom lung cancer had been diagnosed were included.Results: Unknown stage was more common in people with severe disabilities (13.1% versus 10.3%), especially those with a communication (14.2%) or mental/cognitive disability (15.7%). People with disabilities were less likely to undergo a surgical procedure (adjusted OR [aOR] ¼ 0.82, 95% confidence interval [CI]: 0.77-0.86), chemotherapy (aOR ¼ 0.80, 95% CI: 0.77-0.84), or radiotherapy (aOR ¼ 0.92, 95% CI: 0.88-0.96). This higher likelihood was more evident for people with severe communication impairment (aORs of 0.46 for surgery and 0.64 for chemotherapy) and severe brain/mental impairment (aORs 0.39 for surgery, 0.47 for chemotherapy, and 0.49 for radiotherapy). Patients with disabilities had a slightly higher overall mortality than did people with no disability (adjusted hazard ratio ¼ 1.08, 95% CI: 1.06-1.11), especially in the group with a severe disability (a hazard ratio ¼ 1.20, 95% CI: 1.16-1.24). Conclusions:Patients with lung cancer and disabilities, especially severe ones, underwent less staging work-up and treatment even though their treatment outcomes were only slightly worse than those of people without a disability. Although some degree of disparity might be attributed to reasonable clinical judgement, unequal clinical care for people with communication and brain/mental disabilities suggests unjustifiable disability-related barriers that need to be addressed.

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Health care utilization by people with disabilities: A longitudinal analysis of the Korea Welfare Panel Study (KoWePS)

Cited by 45 publications

References 38 publications

Use of health services by Brazilian older adults with and without functional limitation

Use of health services by Brazilian older adults with and without functional limitation

Challenges in Accessing Health Care for People with Disability in the South Asian Context: A Review

Disparities in the Diagnosis and Treatment of Lung Cancer among People with Disabilities

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