Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Regional Variation of EQ-5D Index and Related Factors in Community Health Survey: Major Role of Psychosocial Factors in Korea

지역사회건강조사에서 EQ-5D index의 지역간 변이와 관련 요인: 사회심리적 요인의 중요성

  • Kim, Eunsu (Department of Public Health, Graduate School, Chungnam National University) ;
  • Nam, Hae-Sung (Department of Preventive Medicine, College of Medicine, Chungnam National University and Research Institute for Medical Sciences)
  • 김은수 (충남대학교 일반대학원 보건학과) ;
  • 남해성 (충남대학교 의과대학 예방의학교실 및 의학연구소)
  • Received : 2020.10.30
  • Accepted : 2020.12.16
  • Published : 2020.12.31
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Abstract

Objectives: As an ecological study, this study was performed to identify the community-level variation of health related quality-of-life (HRQOL), and to explore the factors that explain the variation, using 2017 Korean Community Health Survey (KCHS) data. Methods: Community health indicators of KCHS, which are correlated with the EQ-5D index of Si-gun-gu districts, were selected as independent variables. Multiple linear regression model was used to derive factors that explain regional variations in the EQ-5D index. Results: The EQ-5D index variation in 229 districts nationwide was 1.1 times for extremal quotient (EQ) and 1.0 for coefficient of variance (CV). The Si-gun-gu districts with the EQ-5D index in the lower 25% were more distributed in the province (27.7%) than in the metropolitan area (20.3%). As a result of multiple linear regression analysis, the depressed mood experience rate, perceived stress rate, suicide ideation rate, and physician diagnosed arthritis rate were derived as major factors of the variation. Conclusions: In order to reduce the gap in HRQOL between the districts, the priority of local health policies should be placed on the above factors including psychosocial factors.

이 연구는 생태학적 연구로서 EQ-5D index로 측정되는 건강수준의 시군구 단위 변이를 파악하고 지역사회건강조사 지표에서 이러한 변이를 설명하는 요인을 탐색하고자 하였다. 2017년도 지역사회건강조사자료에서 산출되는 전국 229개 시군구의 EQ-5D index 변이는 EQ(격차비) 1.1배, CV(변이계수) 1.0으로 지역 간 변이는 연구에 포함된 독립변수들에 비해 상대적으로 작았다. EQ-5D index 값이 전국 하위 25%에 속하는 시군구 비중이 높은 광역시도는 전라북도(9개 시군, 64.3%)와 충청남도(7개 시군, 46.7%)이었다. 다중 선형회귀분석 결과 지역 간 변이의 주요요인으로 우울감 경험률, 스트레스 인지율, 자살 생각률, 관절염진단 경험률 등이 도출되었다. 지역 간 건강수준의 격차를 줄이기 위해서는 사회심리적 요인들을 포함한 상기 요인들의 개선에 우선순위를 두어야 할 것으로 사료된다.

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