The Association between Chronic Diseases and Active Patient Participation
- Yang Keun Kim, Hye Won Kim, Jae Yong Paik, Chang Bin Hong, Kayoung Lee, Tae-Jin Park, Jinseung Kim
- Received June 14, 2017 Accepted August 09, 2017
- ABSTRACT
-
- Background:
- Active patient participation in health care decision-making can results in better medical outcomes. This study's purpose is to investigate the association between the patient participation and the diseases often encountered in primary care.
- Methods:
- We used the data from the Korean National Health and Nutrition Examination Survey conducted in 2015 which included 4,158 adults aged older than 19 and who had no missing data. The association between the presence of disease or the number of accompanying diseases and the active patient participation in the treatment decision was studied. Logistic regression analysis was conducted using complex sampling design in each sex.
- Results:
- After adjusting for confounding variables, the relationship between active patient participation and the diagnosis of hypertension, odds ratio (OR) was 1.95 (95% confidence interval [CI], 1.25-3.04) for men and 1.83 (95% CI, 1.27-2.65) for women. In women diagnosed with diabetes, OR was 0.58 (95% CI, 0.35-0.97). Between active patient participation and increasing number of accompanying diseases have positive tendency but not statistically significant.
- Conclusions:
- This study suggests that active patient participation is related to the diagnosis of hypertension, and the number of accompanying diseases and active patient participation were not significantly associated. This is a rare study related to the active patient participation in the Korean population, that it may be helpful in establishing further relevant research and strategies to increase the patient participation rate.
Table 1.
The relationships of active patient participation with age, household income, education level, private insurance, and disease
| Men | Women | |||
|---|---|---|---|---|
| % (SE) | Pa | % (SE) | Pa | |
| Age (y) | 0.493 | 0.238 | ||
| 19-29 | 85.2 (2.5) | 84.9 (2.0) | ||
| 30-39 | 85.4 (2.6) | 89.1 (1.6) | ||
| 40-49 | 84.3 (2.7) | 87.0 (1.9) | ||
| 50-59 | 87.2 (2.3) | 87.8 (1.7) | ||
| 60-69 | 89.8 (1.7) | 89.6 (1.6) | ||
| 70-79 | 90.3 (2.3) | 91.6 (1.7) | ||
| More than 80 | 90.7 (5.0) | 84.9 (4.6) | ||
| Household income | 0.171 | 0.459 | ||
| Low | 86.1 (2.5) | 89.7 (1.4) | ||
| Low-middle | 83.6 (2.3) | 86.8 (1.4) | ||
| High-middle | 89.5 (1.7) | 88.6 (1.3) | ||
| High | 85.9 (1.8) | 87.0 (1.4) | ||
| Education level | 0.920 | 0.179 | ||
| Less than elementary school | 88.0 (2.5) | 88.5 (1.6) | ||
| Middle school | 86.5 (3.1) | 92.2 (1.7) | ||
| High school | 86.7 (1.6) | 87.4 (1.4) | ||
| College or higher | 86.0 (1.6) | 86.8 (1.3) | ||
| Private insurance | 0.995 | 0.201 | ||
| Yes | 86.5 (1.2) | 87.5 (0.8) | ||
| No | 86.5 (2.0) | 89.7 (1.4) | ||
| Chronic disease | ||||
| Diabetes mellitus | 0.675 | 0.454 | ||
| Yes | 87.7 (2.8) | 85.9 (2.7) | ||
| No | 86.4 (1.1) | 88.0 (0.8) | ||
| Asthma | 0.251 | 0.702 | ||
| Yes | 79.3 (7.0) | 86.4 (4.2) | ||
| No | 86.8 (1.0) | 87.9 (0.7) | ||
| Hypertension | <0.001 | 0.001 | ||
| Yes | 92.1 (1.2) | 91.9 (1.1) | ||
| No | 84.9 (1.2) | 86.9 (0.9) | ||
| Dyslipidemia | 0.060 | 0.332 | ||
| Yes | 90.7 (2.1) | 89.5 (1.6) | ||
| No | 85.9 (1.1) | 87.6 (0.9) | ||
| Stroke | 0.060 | 0.312 | ||
| Yes | 93.4 (3.8) | 91.6 (3.3) | ||
| No | 86.4 (1.0) | 87.8 (0.7) | ||
| Angina pectoris or MI | 0.136 | 0.628 | ||
| Yes | 92.7 (3.6) | 89.7 (3.5) | ||
| No | 86.4 (1.0) | 87.8 (0.8) | ||
| Depression | 0.203 | 0.592 | ||
| Yes | 78.7 (6.9) | 86.3 (3.0) | ||
| No | 86.7 (1.0) | 88.0 (0.8) | ||
Table 2.
Odds ratio for active patient participation according to the diagnosis of disease by logistic regression
| Disease | Sex | Adjusted OR (95% CI)a | Pb |
|---|---|---|---|
| Diabetes mellitus | Men | 0.82 (0.43-1.55) | 0.538 |
| Women | 0.58 (0.35-0.97) | 0.038 | |
| Asthma | Men | 0.57 (0.24-1.36) | 0.204 |
| Women | 0.85 (0.41-1.74) | 0.649 | |
| Hypertension | Men | 1.95 (1.25-3.04) | 0.003 |
| Women | 1.83 (1.27-2.65) | 0.001 | |
| Dyslipidemia | Men | 1.27 (0.72-2.26) | 0.408 |
| Women | 1.04 (0.66-1.64) | 0.863 | |
| Stroke | Men | 1.66 (0.46-6.01) | 0.437 |
| Women | 1.03 (0.41-2.59) | 0.949 | |
| Angina pectoris or MI | Men | 1.65 (0.58-4.67) | 0.346 |
| Women | 0.90 (0.39-2.06) | 0.800 | |
| Depressive disorder | Men | 0.59 (0.24-1.46) | 0.252 |
| Women | 0.77 (0.44-1.32) | 0.337 |
Table 3.
Odds ratio for active patient participation according to the number of diseases by logistic regression
| Sex | Number of diseases | Adjusted OR (95% CI)a |
|---|---|---|
| Both (n=4,158) | ||
| 0 (n=2,386, 57.4) | 1 | |
| 1 (n=969, 23.3) | 1.12 (0.84-1.50) | |
| 2 (n=526, 12.7) | 1.22 (0.81-1.83) | |
| More than 3 (n=277, 6.7) | 1.55 (0.90-2.65) | |
| Men (n=1,702) | ||
| 0 (n=958, 56.3) | 1 | |
| 1 (n=416, 24.4) | 1.145 (0.74-1.77) | |
| 2 (n=222, 13.0) | 1.376 (0.78-2.44) | |
| More than 3 (n=106, 6.2) | 2.570 (0.94-7.01) | |
| Women (n=2,456) | ||
| 0 (n=1,428, 58.1) | 1 | |
| 1 (n=553, 22.5) | 1.11 (0.75-1.65) | |
| 2 (n=304, 12.4) | 1.10 (0.62-1.96) | |
| More than 3 (n=171, 7.0) | 1.11 (0.59-2.05) |
Table 4.
Analysis of changes in outcome with or without hypertension in dyslipidemia patients
| Sex | Controla | Hypertension without dyslipidemia | Dyslipidemia without hypertension | Dyslipidemia with hypertension |
|---|---|---|---|---|
| OR (95% CI)b | ||||
| Men | 1,099 (64.6) | 339 (19.9) | 98 (5.8) | 166 (9.8) |
| 1 | 2.01 (1.24-3.27) | 1.32 (0.60-2.94) | 2.30 (1.10-4.81) | |
| Women | 1,615 (65.8) | 337 (13.7) | 218 (8.9) | 286 (11.6) |
| 1 | 1.60 (1.01-2.54) | 0.92 (0.54-1.57) | 2.19 (1.25-3.83) | |
Table 5.
Analysis of changes in outcome with or without hypertension in stroke patients
| Sex | Controla | Hypertension without stroke | Stroke without hypertension | Stroke with hypertension |
|---|---|---|---|---|
| OR (95% CI)b | ||||
| Men | 1,181 (69.4) | 466 (27.4) | 16 (0.9) | 39 (2.3) |
| 1 | 1.88 (1.185-2.981) | 0.98 (0.17-5.57) | 6.38 (1.40-29.13) | |
| Women | 1,821 (74.1) | 581 (23.7) | 12 (0.5) | 42 (1.7) |
| 1 | 1.84 (1.26-2.68) | 1.10 (0.21-5.70) | 1.80 (0.61-5.34) | |
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