Gender Differences in the Risk of Ischemic Heart Disease According to Healthcare Utilization and Medication Adherence among Newly Treated Korean Hypertensive Patients

Jiae Shin, Dongwoo Ham, Hee Young Paik, Sangah Shin and Hyojee Joung
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Jiae Shin: Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
Dongwoo Ham: Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
Hee Young Paik: Center for Gendered Innovations in Science and Technology Research (GISTeR), Korea Federation of Women’s Science & Technology Associations, 22 Teheran-ro 7-gil, Gangnam-gu, Seoul 06130, Korea
Sangah Shin: Department of Food and Nutrition, School of Food Science and Technology, Chung-Ang University, 4726 Seodong-daero, Daedeok-myeon, Gyeonggi-do, Anseong 17546, Korea
Hyojee Joung: Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea

IJERPH, 2021, vol. 18, issue 3, 1-13

Abstract: We aimed to investigate gender differences in ischemic heart disease (IHD) according to healthcare utilization and medication adherence among newly treated Korean hypertensive adults. The National Sample Cohort version 2.0 of the National Health Insurance Service was used for analysis. Newly treated hypertensive patients ? 20 years and without IHD in 2002 were selected from a population that underwent health examination during 2003–2006. Of those patients, 11,942 men and 11,193 women were analyzed and followed up for 10 years. We determined the association between IHD and healthcare utilization and medication adherence using the Cox proportional hazards model. Hypertensive women patients had a lower risk of IHD than men patients (hazard ratio [HR] = 0.93, 95% confidence interval [CI] 0.88–1.00). The IHD risk was increased in patients who visited healthcare providers > 12 times/person-year (HR = 2.97, 95% CI 2.79–3.17), paid high out-of-pocket expense/person-year (HR = 1.55, 95% CI 1.41–1.69), and had medication nonadherence (HR = 1.67, 95% CI 1.58–1.77). However, the risk was decreased in patients who used both urban and rural areas (HR 0.75, 95% CI 0.67–0.84) and mixed types of providers (HR = 0.93, CI 0.88–0.99). The risk of IHD was significantly different between men and women only in the visiting frequency to healthcare providers (men, HR = 3.21, 95% CI 2.93–3.52; women, HR = 2.78, 95% CI 2.53–3.04, p for interaction = 0.0188). In summary, the risk of IHD was similar according to healthcare utilization and medication adherence between men and women, except visiting frequency to healthcare providers.

Keywords: gender differences; ischemic heart disease; healthcare utilization; medication adherence; National Health Insurance Service (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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