[Factors affecting national health insurance mass screening participation in the disabled].
OBJECTIVE
As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled.


METHODS
In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income; disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables.


RESULTS
The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan regions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health insurance program for the self-employed than for employees (95% CI=2.56-2.63); 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23); 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI= 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40).


CONCLUSIONS
The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.
Park
Jong-Hyock
JH
Department of Health Policy and Management, Seoul National University College of Medicine.
Lee
Jin-Seok
JS
Lee
Jin-Yong
JY
Hong
Ji-Young
JY
Kim
So-Young
SY
Kim
Seong-Ok
SO
Cho
Byong-Hee
BH
Kim
Yong-Ik
YI
Shin
Youngsoo
Y
Kim
Yoon
Y
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors