Miscellaneous |
Disparities between persons with and without disabilities in their participation rates in mass screening
Jong-Hyock Park1, Jin-Seok Lee2,4, Jin-Yong Lee2, Jin Gwack3, Jae-Hyun Park1, Yong-Ik Kim2 and Yoon Kim2,4
1 Division of Cancer Policy and Management, National Cancer Control Research Institute, National Cancer Center
2 Department of Health Policy and Management, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
3 Department of Preventive Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
4 Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, South Korea
Correspondence: Yoon Kim, MD, PhD, Seoul National University College of Medicine, Yeongeon-dong, Jongno-gu, Seoul 110-799, South Korea, tel: +82-2-2072-3124, fax: +82-2-743-2009, e-mail: yoonkim{at}snu.ac.kr
Received April 16, 2008 , accepted October 10, 2008
Objectives: The purpose of this study was to determine the number of persons with and without disabilities who participated in the National Health Insurance (NHI) chronic disease mass screening programs in South Korea. Methods: The data were obtained from mass screening claims submitted to the NHI and National Disability Registry. Factors affecting the participation rate included demographic variables, socioeconomic status, residential region, and disability type and severity. A multiple logistic regression analysis was used to evaluate the relationship between participation rates and disability type and severity adjusted for confounding factors. Results: The analysis revealed that persons with a disability were less likely to participate in mass screening programs than those without a disability (35.8% vs. 40.2%). Multiple logistic regression analysis indicated that persons with severe disabilities had lower participation rates than those without disabilities [adjusted odds ratio (aOR): 0.64, 95% confidence interval (CI): 0.63–0.64]. In particular, persons with severe disabilities such as limb, brain, visual and internal organ impairment, were less likely to participate in the mass screening programs. However, persons with mild disability had higher participation rates than those without disabilities (1.03, 1.02–1.03). Conclusions: Although the prevalence rates of chronic diseases are higher among persons with disabilities, various types of impairments such as limb, brain, visual and internal organ impairment, hinder participation in mass screening programs for chronic diseases. The reasons for this disparity must be investigated and health policies must be altered to make preventative treatments more accessible to persons with disabilities.
Keywords: equity, mass screening, National Health Insurance, participation rate, persons with disabilities