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Abstract
Methods
The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. This survey included 1, 257 people aged 40 years and older with a history of diabetic mellitus who answered questions, "Within one year, have you ever received eye examination (fundus photography) for screening diabetic retinopathy?" Factors that affect care of diabetic retinopathy were identified using multiple logistic regression analysis.
Results
Among the 1,257 people aged 40 years and older, 464 (36.9%) received screening for diabetic retinopathy. People aged 65 years and older (aOR = 0.7, 95% CI: 0.51-0.85) with university education (aOR = 0.5, 95% CI: 0.32-0.74) were more likely to undergo screening for diabetic retinopathy compared to those in the reference category (40-64 years old and those who had elementary school or lower education). People living in rural areas were less likely to undergo screening for diabetic retinopathy compared to those living in urban areas (aOR = 1.7, 95% CI: 1.32-2.24). Diabetic retinopathy screening was also associated with self-reported health status (ref: unhealthy [aOR = 1], fair [aOR = 1.7, 95% CI: 1.25-2.23], and healthy [aOR = 1.8, 95% CI: 1.30-2.44]).
Conclusions
To increase nationwide screening rates for diabetic retinopathy, more attention should be given to underserved groups, particularly people aged between 40 and 64 years, those with a low education level, those living in rural areas, and those with a positive attitude toward self-reported health status. These issues highlight the need for a new emphasis in health education and public health policies aimed towards these underserved groups.
Figures and Tables
Table 1
Characteristic of study population (n = 1,257)
*To derive income per adult equivalent, we defined as household 'income / square root of person'; †The term 'spouse' refers to an individual who is legally married or cohabiting, 'without spouse' refers to an individual who is single, divorced, or separated; ‡Lifetime smoker included respondents who reported that they have smoked at least 100 cigarettes in their lifetime and now smoke; §Moderate-intensity activities as that lasting 10 minutes or more and increasing heart rate slightly compared with sedentary lifestyle.
Table 2
Factors associated with care of diabetic retinopathy* - Univariate analysis (n = 1,257)
*Subjects were asked the following question: "Have you ever had an eye examination (or fundus examination) for screening of diabetic retinopathy within one year?" with response of "yes" and "no"; †To derive income per adult equivalent, we defined as household 'income / square root of person'; ‡The term 'spouse' refers to an individual who is legally married or cohabiting, 'without spouse' refers to an individual who is single, divorced, or separated; §Lifetime smoker included respondents who reported that they have smoked at least 100 cigarettes in their lifetime and now smoke; ∥Moderate-intensity activities as that lasting 10 minutes or more and increasing heart rate slightly compared with sedentary lifestyle.
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