The Equity in Health Care Utilization of One-Person Households: By Comparison with Multi-Person Households / 보건행정학회지

BACKGROUND: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). METHODS: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. RESULTS: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. CONCLUSION: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.

Trajectories of Self-rated Health among One-person Households: A Latent Class Growth Analysis

PURPOSE: The aim of this study is to explore different types of self-rated health trajectories among one-person households in Korea.METHODS: We used five time-point data derived from Korea Health Panel (2011~2015). A latent growth curve modeling was used to assess the overall feature of self-rated health trajectory in one-person households, and a latent class growth modeling was used to determine the number and shape of trajectories. We then applied multinomial logistic regression on each class to explore the predicting variables.RESULTS: We found that the overall slope of self-rated health in one-person households decreases. In addition, latent class analysis demonstrated three classes: 1) High-Decreasing class (i.e., high intercept, significantly decreasing slope), 2) Moderate-Decreasing class (i.e., average intercept, significantly decreasing slope), and 3) Low-Stable class (i.e., low intercept, flat and nonsignificant slope). The multinomial logistic regression analysis showed that the predictors of each class were different. Especially, one-person households with poor health condition early were at greater risk of being Low-Stable class compared with High-Decreasing class group.CONCLUSION: The findings of this study demonstrate that more attentions to one-person households are needed to promote their health status. Policymakers may develop different health and welfare programs depending on different characteristics of one-person household trajectory groups in Korea.

Home Meal Replacement Use and Eating Habits of Adults in One-Person Households / 대한지역사회영양학회지

OBJECTIVES: The rise of one-person households may have consequences for food consumption patterns, and eating habits. This study investigated the home meal replacement (HMR) use and eating habits among adults in their 20s-30s living in one-person households.METHODS: A total of 247 adults aged 26–39 years participated in this study. The subjects were divided into three group according to the household type; one-person households (n=80), two-person households (n=49), and multi-family (three and more members) households (n=118). Their use of HMRs (classified as ready-to-eat, ready-to-cook, and fresh convenience foods) and their eating habits were all compared.RESULTS: The mean age of the subjects was 30.5 years, 47.8% were male, and there was no significant difference in age, gender, occupation, and monthly income according to the type of household. The intake frequency of total HMR and ready-to-eat foods was significantly higher in one-person households among the three groups. People in one-person households consumed more HMRs alone, and spent more money to buy HMRs. Undesirable dietary habit scores like unbalanced eating (p<0.05) and eating salty foods (p<0.05) were significantly higher in the one-person households. Among the total subjects, the unbalanced eating scores showed a significant positive correlation with the intake frequency of ready-toeat foods, while the unbalanced eating scores showed negative correlation with the preference of fresh convenience foods. The scores for eating salty foods showed a significant positive correlation with the intake frequency and preference of ready-to-eat foods and ready-to-cook foods, while there was negative correlation with the intake frequency and preference of fresh convenience foods.CONCLUSIONS: Adults in their 20s–30s in one-person households consumed more ready-to-eat foods than those in multi-family households. In addition, people with one-person households had more unbalanced diets and ate more salty foods, and these undesirable eating habits showed a significant positive correlation with the use of ready-to-eat or ready-to-cook foods. These results should be addressed for producing healthier ready-to-eat/ready-to-cook foods and implementing nutrition education for making healthy food choices of one-person households, which are steadily increasing.

Comparison of Risk Factors for Type 2 Diabetes Mellitus in One-Person Households and Multi-Person Households

BACKGROUND: Recently, the number of one-person households has increased, and the prevalence of type 2 diabetes mellitus has risen in Korea. Major complications of diabetes, such as stroke and myocardial infarction are major causes of death. Therefore, we conducted this study to test the hypothesis that the risk factors and prevalence of type 2 diabetes mellitus differ between one-person and multi-person households.METHODS: This retrospective study analyzed data of 3,691 adults over 19 years old from the 7th (2016) Korea National Health and Nutrition Examination Survey. Data were analyzed by composite sampling for age, family history, waist circumference, body mass index, hypertension, high-density lipoprotein cholesterol, triglycerides, smoking, alcohol consumption, physical activity, and consumption of breakfast. Multivariate logistic regression analysis was performed by household-type in order to estimate the relative risk of factors associated with diabetes.RESULTS: Hypertension was a significant risk factor for diabetes in both groups. Among other diabetic risk factors, individuals in one-person households were more likely to skip breakfast and less likely to engage in physical activity than those in multi-person households.CONCLUSION: One-person households have a high risk of hypertension, skipping breakfast, and poor physical activity. It is important to consider the role of one-person households when studying the management and treatment of disease.

Total Knee Arthroplasty for Treating Valgus and Varus in the Knees of One Person

PURPOSE: We have performed total knee arthroplasty for treating valgus and varus in the knees of one person. We investigated the clinical characteristics of these patients and the relationship between the kind of deformity and the postoperative result. MATERIALS AND METHODS: From March 2002 to May 2005, fourteen patients who had simultaneous varus and valgus knee deformities underwent total knee arthroplasties and they were followed for more than 12 months, and these were the subjects of our study. The average age was 64.6.years and the average follow-up period was 18.4 months. Follow-up imaging assessments were done and the clinical outcomes were evaluated using the HSS score at the last follow-up. RESULTS: Nine cases had more pain in the varus knee preoperatively and two cases had more pain in the valgus knee preoperatively. In 8 cases, degenerative scoliosises were associated with the knee deformity and among these cases, seven cases had vlagus deformities in the right knees. In two cases, hip deformities were noted in the ipsilateral side of the valgus deformity. The preoperative mean valgus angle and varus angle was 10.5 degrees and 7.8 degrees, respectively. The postoperative valgus and varus angle improved to 6.8 and 6.0 degree, respectively. The HSS score improved from 64.7 to 86.0 points for the valgus deformities and from 61.5 to 86.9 points for the varus deformities. Postoperative patellar clunk syndrome was identified in one valgus knee and arthroscopic resection was then performed. The knee had completely recovered on the last follow-up. CONCLUSION: Simultaneous or staged total knee arthroplasties in patients with simultaneous varus and contralateral valgus knee deformities achieved satisfactory outcomes with regard to the objective orthopedic criteria as well as the overall patient satisfaction in terms of pain relief and function. We found that scoliosis and ipsilateral hip deformities concurred with knee deformities, and this indicated that hip deformity and scoliosis are related with knee deformities. We found no significant difference between the kind of deformity and the postoperative result, yet a prospective study with more cases and longer follow-up is recommended in the future to reaffirm our findings.