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국내 백내장 수술 현황과 향후 전망: 국민건강 영양 조사자료
임형택,우영제,박현주,김성수,대한안과학회역학조사위원회,Tyler Hyung Taek Rim,Young Jae Woo,Hyun Joo Park,Sung Soo Kim,The Epidemiologic Survey Committee in the Korean Ophthalmological Society 대한안과학회 2014 대한안과학회지 Vol.55 No.12
Purpose: To identify socio-demographic factors in cataract surgery in Korea and expect future effect of the bundle of service system. Methods: We analyzed the number of people undergoing cataract surgery and associated factors such as surgery ratio, region, age, income, and insurance status of 28,980 patients older than 40 years using data from the fifth Korea National Health and Nutrition Examination Survey 2008-2012 (KNHANES). Results: Among total population in 2012, 47.5% of elderly aged 80 years and older have received cataract surgery. According to region in patients older than 40, Jeollanam-do showed the highest proportion of patients undergoing cataract surgery, at 12%, Daejeon showed the lowest proportion of 3.6%, and Seoul showed 6.8%. Regional analysis was also performed by analyzing the number of cataract patients per ophthalmologist. Jeollanam-do showed the highest with 40,115 patients per ophthalmologist, and Seoul showed the least with 1,094 patients per ophthalmologist. The sociodemographic factors such as education or income, were not associated with cataract surgery after adjusting for age and regional difference. On the other hand, subjects with medicaid were associated with 1.6-fold (95% confidence interval, 1.3-2.0) higher rate of cataract surgery than subjects with national health insurance. Conclusions: Regional disparity was found in the cataract surgery rate and surgery rate per an ophthalmologists, whereas sociodemographic factors were not significant in receiving benefits of cataract surgery. Before the amount of bundled payment is changing, down-leveling of quality of care and deepening of disparities among health care provider should be considered.J Korean Ophthalmol Soc 2014;55(12):1772-1778
임형택,이동민,정은지 대한안과학회 2013 대한안과학회지 Vol.54 No.1
Purpose: To evaluate the health-related quality of life (QOL) in Koreans according to visual acuity. Methods: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. The present study included 11,022 Koreans who completed the KNHANES IV. The relation of visual acuity and QOL was verified, and EuroQoL 5D (EQ-5D) was identified using the adjusted mean based on linear regression analysis. Results: As visual acuity decreased, QOL decreased. QOL in mobility, usual activities, and pain/discomfort were affected by the vision gradient, while self-care and anxiety/depression were less influenced by the vision gradient. In particular, QOL in usual activities was significantly affected by the visual gradient. Subjects with a visual acuity of 1.6-3.0 were less likely to have a low QOL in usual activities compared to subjects with a visual acuity of 0.0-0.5 as a reference group (adjusted Odds Ratio = 23.6, 95% CI, 4.8-115.5). QOL in usual activities was statistically low in subjects older than 65 years of age, with low household monthly income, low education, and living without a spouse. Conclusions: As visual acuity decreased, QOL in the aspect of mobility, usual activities, and pain/discomfort decreased severely, which resulted from activity limitation. Considering that the risk group with increasing age, low income, low education, and living without a spouse had lower QOL, the most important is to increase activity, which can induce the improvement of QOL in Koreans who have low visual acuity and related risk factors is.