1,721,414 research outputs found
Effect of smoking on health service utilization.
No full text보건학과/박사[한글]
흡연이 질병발생의 위험을 높인다는 지금까지의 역학적인 연구에도 불구하고 과연 흡연이 의료이용을 증가시키는가 하는 점에 대해서는 학자들간의 논란이 많다. 이 연구는 흡연이 질병이환과 의료이용을 증가시키는지를 알아보고자 하였다.연구자료는 1989년 국민건강조사 자료이며 그중 흡연조사가 실시되었던 5,20명을 연구표본으로 하여 흡연력에 따라 질병이환과 의료이용을 비교하였다. 주요결과는 다음과 같다.
첫째, 다변수로지스틱 모형에 의하면 다른 조건이 일정할 때 급성질환의 유병률은 비흡연자에 비해 남자 과거흡연자는 1.9배 여자 흡연자는 1.7배로 유의하게(p<0.05) 높았다.남자 흡연자의 흡연시작연령이 18세 이하인 경우 비흡연자에 비해 급성질환 유병률이 2.4배로 유의하게(p<0.05)높았다.
만성질환의 유병률은 비흡연자에 비해 남자 과거흡연자가 1.4배로 높았으나 유의하지는 않아다.
둘째, 과거흡연자는 비흡연자에 비해 입원이용과 외래이용을 더 많이 하였다. 입원이용은 여자인 경우 현재흡연자에게 비흡연자에 비해 2.5배 많았고, 외래이용은 남자인 경우과거흡연자에서 2.1배, 흡연시작연령이 18세 이하에서 2.3배, 그리고 여자인 경우 현재흡
연자에게 1.5배 많았다. 또한 과거흡연자가 건강에 관한 관심이 있는 경우 그렇지 않은 경우에 비해 외래이용을 3.4배 더 많이 하였으며 이들은 모두 통계학적으로 유의하였다.
셋째, 가중희귀분석 모형에 의하면 다른 조건이 일정할 때 남자 외래 치료일수가 현재 흡연자와 과거흡연자에서 비흡연자보다 유의하게 길었다. 그러나 여자의 경우는 흡연여부 별 치료일수가 유의한 차이가 없었다.
이 연구는 흡연은 급성 및 만성질환의 이환은 물론 입원 및 외래이용의 증가에 영향을 준다는 결론을 유도하였다.
향후 이 연구와 관련하여 오랜기간 추적된 표본을 가지고 질병별로 이환과 의료이용에 관한 심층분석으로 흡연이 국민건강에 미치는 영향을 좀더 분명하게 밝힐 필요가 있다고 생각한다.
핵심되는 말 : 흡연, 질병이환, 의료이용
[영문]
It is well known that smoking increases the prevalence of diseases. During recent years, studies on the effect of smoking on health service utilization have brought about wide dispute among researchers.
This study involved direct observation of the differences in prevalence of disease and utilization of medical care by smokers, non-smokers, and ex-smokers. The data which were collected for the 1989 Korean National Health Survey(1989 KNHS) were used. The KNHS selected random sample of 5,201 individuals aged 20 to 59
representative of the whole Korean population.
Research findings are as fellows :
1. The risk for prevalence of diseases was increased among ex-smokers. The diseases showing increased positive risks included acute disease(relative risk, RR=1.9 for ex-smokers vs non-smokers) among male. and acute disease(RR=1.7 for current smokers) among female.
2. Smokers admitted to hospital during the years preceding the interview more than non-smokers, and also ex-smokers used more outpatient services and inpatient services than non-smokers. Health services showed significantly elevated positive risks related to smoking behavior were admission(RR=2.5 for current smokers) among female, outpatient visits(RR=2.1 for ex-smokers, RR=2.3 for age started smokings was less than 18 years) among male and (RR=1.5 for current smokers) among female.
The interaction term between the ex-smokers and the self-concern on health status was statistically significant in multiple regression model which explained the rate for outpatient visits(RR=3.4 for ex-smoker) among male.
3. The days of medication were statistically significantly increased in current smokers and ex-smokers in the weighted least square regression model among mate.
These effects persisted after controlling for major identified potential confounding factors.
Thus, the results of this study confirm that smoking is an important cause of prevalence of diseases and a major contributory factor to the use of health services.
Key words : Smoking, Prevalence of disease, Health service utilizationrestrictio
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