고혈압-당뇨병군의 사회경제적 수준과 건강관련 삶의 질 관계

Abstract

고혈압과 당뇨병은 동반 발병이 되는 경향이 높고, 대사성질환 및 심뇌혈관질환을 유발시키는 위험인자로 알려져 있다. 이 질환에 유병된 환자의 경우 교육과 월평균가구소득 수준이 건강관련 삶의 질에 영향을 줄 것으로 판단된다. 그러므로 EQ-5D를 이용하여 정상군, 고혈압 또는 당뇨병군, 고혈압과 당뇨병군에 따른 사회경제적 수준의 지표인 교육수준 및 월평균가구소득과 건강관련 삶의 질과의 관련성을 파악하였다.|Hypertension and diabetes, which tend to show a high incidence of comorbidities, are known to be the risk factors for metabolic and cardiovascular diseases. In the case of the patients with these diseases, it has been determined that the level of education and monthly average household income may affect the health- related quality of life. Therefore, we used EQ-5D to investigate the relationship between education level and monthly average household income, which are the indicators of socio-economic level, and health-related quality of life in terms of normal group, hypertension or diabetes group, hypertension and diabetes group. By merging the data from the National Health and Nutrition Examination Survey, which is weighted to represent South Korean adults, organized by the Korea Centers for Disease Control and Prevention, from 2013 to 2015, we chose 4,130 adults aged 19 years or older as the final subjects for this study. Data analysis was conducted using statistical program SPSS version 23.0. The relationship between monthly average household income(MAHI) and education level and health-related quality of life (HRQOL) was analyzed using multiple regression analysis. As a result, in the hypertensive or diabetic group, the level of quality of life in the group with the education below junior high school graduation was significantly lower than that of the group with the education over college graduation with the quality of life regression coefficient of –0.025 while there was no significant result in the case of high school graduates. The quality of life in the group with the MAHI of KRW 1.5 million or less was significantly lower than that of the group with the MAHI of KRW 3 million or more with the quality of life regression coefficient –0.029 while there was no significant results in the group with the MAHI between KRW 1.5 million or less and KRW 3 million. In the hypertensive and diabetic group, in terms of education level, the level of quality of life in the group with the education below junior high school graduation was significantly lower than that of the group with the education over college graduation with the quality of life regression coefficient of –0.073 while there was no significance in the case of high school graduates. In the case of MAHI, not all group showed significant difference. Therefore, the results of this study were somewhat different from the results of the previous studies, which had claimed that the lower the education level and income level, the lower the quality of life. In conclusion, in the case of the educational level in terms of hypertension– diabetes comorbidities, we found that significant socio-economic level variables in health-related quality of life included the low education level below junior high school graduation and low monthly income earning less than KRW 1.5 million. In the future, In the case of the health of low-education and low-income people with hypertension and diabetes, we propose that much efforts and improvement plans should be actively employed in the future to improve their quality of life. Keywords : Socioeconomic status, Health-Related Quality of Life, EuroQol-5 Dimension (EQ-5D), Hypertension and Diabetes