Individual socioeconomic status and risk of out‐of‐hospital cardiac arrest: A nationwide case–control analysis

Abstract

Objectives: Area-level socioeconomic status (SES) is associated with the incidence of out-of-hospital cardiac arrest (OHCA); however, the effects of individual-level SES on OHCA occurrence are unknown. This study investigated whether individual-level SES is associated with the occurrence of OHCA.Methods: This case-control study used data from the nationwide OHCA registry and the National Health Information Database (NHID) in Korea. All adult patients with OHCA of a medical etiology from 2013 to 2018 were included. Four controls were matched to each OHCA patient based on age and sex. The exposure was individuallevel SES measured by insurance type and premium, which is based on income in Korea. National Health Insurance (NHI) beneficiaries were divided into four groups (Q1-Q4), and medical aid beneficiaries were separately classified as the lowest SES group. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the outcomes were calculated. Stratified analyses were conducted according to age and sex.Results: A total of 105,443 cases were matched with 421,772 controls. OHCA occurred more frequently in the lower SES groups. Compared with the highest SES group (Q1), the aORs for OHCA occurrence increased as the SES decreased (aORs [95% CI] were 1.

Evaluation of Socioeconomic Position and Survival After Out-of-Hospital Cardiac Arrest in Korea Using Structural Equation Modeling

“…NHI Q1 indicates beneficiaries with NHI premiums in the highest quartile, and NHI Q4 indicates beneficiaries with NHI premiums in the lowest quartile among the total Korean NHI beneficiary population . NHI Q1 was the highest SEP group, while MA was the lowest SEP group, similar to a recently published study . In the year 2015, the mean annual household incomes for the NHI Q1, NHI Q2, NHI Q3, and NHI Q4 groups, which include property and other assets, were approximately $62 000, $41 000, $29 500, and $27 000, respectively .…”

“… 16 NHI Q1 was the highest SEP group, while MA was the lowest SEP group, similar to a recently published study. 17 In the year 2015, the mean annual household incomes for the NHI Q1, NHI Q2, NHI Q3, and NHI Q4 groups, which include property and other assets, were approximately $62 000, $41 000, $29 500, and $27 000, respectively. 18 Type of insurance, NHI premiums, age, sex, residential region, and comorbidities were extracted from the NHID.…”

Sociodemographic Factors and the Risk of Pediatric Out‐of‐Hospital Cardiac Arrest in Ontario, Canada: A Province‐Wide Case–Control Study

“…This is consistent with evidence in adult populations, where individuals living in low SES neighborhoods have an elevated risk of OHCA. 27 , 34 , 35 These disparities may be due to a higher prevalence of some prearrest risk factors in areas with high levels of socioeconomic marginalization. Our sample of cases included children who experienced OHCA due to sudden infant death syndrome or drowning.…”

Establishing the Korean Out-of-Hospital cardiac arrest registry (KOHCAR)

“…Second, external data connections can improve the accuracy of the registry data and expand the utilization of unused variables. Integration with the national health insurance system (the entire population is covered by the national health insurance system in South Korea), which began in 2022, 22 should be further developed and expanded to encompass diverse patient cohorts. Finally, engaging various organizations in OHCA responses and tailoring communication to stakeholders, such as vulnerable community population management organizations, school CPR training programs, workplace first responders, and medical director organizations, is also essential.…”