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. 2023 Jan 30;38(4):e38.
doi: 10.3346/jkms.2023.38.e38.

Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008-2015

Hang A Park  1   2 , Federico E Vaca  3 , Kyunghee Jung-Choi  4 , Hyesook Park  5 , Ju Ok Park  6
Affiliations

Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008-2015

Hang A Park et al. J Korean Med Sci. .

Abstract

Background: Although inequality in traumatic brain injury (TBI) by individual socioeconomic status (SES) exists, interventions to modify individual SES are difficult. However, as interventions for area-based SES can affect the individual SES, monitoring or public health intervention can be planned. We analyzed the effect of area-based SES on hospitalization for TBI and revealed yearly inequality trends to provide a basis for health intervention.

Methods: We included patients who were hospitalized due to intracranial injuries (ICIs) between 2008 and 2015 as a measure of severe TBI with data provided by the Korea National Hospital Discharge Survey. Area-based SES was synthesized using the 2010 census data. We assessed inequalities in ICI-related hospitalization rates using the relative index of inequality and the slope index of inequality for the periods 2008-2009, 2010-2011, 2012-2013, and 2014-2015. We analyzed the trends of these indices for the observation period by age and sex.

Results: The overall relative indices of inequality for each 2-year period were 1.82 (95% confidence interval, 1.5-2.3), 1.97 (1.6-2.5), 2.01 (1.6-2.5), and 2.01 (1.6-2.5), respectively. The overall slope indices of inequality in each period were 38.74 (23.5-54.0), 36.75 (21.7-51.8), 35.65 (20.7-50.6), and 43.11 (27.6-58.6), respectively. The relative indices of inequality showed a linear trend for men (P = 0.006), which was most evident in the ≥ 65-year age group.

Conclusion: Inequality in hospitalization for ICIs by area-based SES tended to increase during the observation period. Practical preventive interventions and input in healthcare resources for populations with low area-based SES are likely needed.

Keywords: Area-Level SES; Health Inequality; Hospitalization Rate; Intracranial Injury; Socioeconomic Status; Traumatic Brain Injury.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Study flow.
KNHDS = Korea National Hospital Discharge Survey.
Fig. 2
Fig. 2. Age-standardized hospitalization rates due to intracranial injury according to area-level deprivation. Rates are shown in sex and study periods.
ICI = intracranial injury, Q1 = least deprived group, Q5 = most deprived group.
Fig. 3
Fig. 3. Time trends in the indices of inequality in intracranial injury-related hospitalization. Estimates are displayed by age group. SII indicates the absolute difference in rate per 100,000 populations. Arrows indicate a significant linear trend.
RII = relative index of inequality, SII = slope index of inequality, CI = confidence interval.
See this image and copyright information in PMC

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