Sex and Economic Disparity Related to Reperfusion Therapies for Patients with Acute Ischemic Stroke in South Korea across a 10-Year Period: A Nationwide Population-Based Study Using the National Health Insurance Database

Jusun Moon, Jinyoung Shin, Jeehye Lee, Ho Jin Jeong, Hyeongsu Kim, Jaehyeong An, Sung Hyun Jo, Kwang-Pil Ko and Jeoungbin Choi
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Jusun Moon: Department of Neurology, National Medical Center, Seoul 04564, Korea
Jinyoung Shin: Department of Family Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul 05030, Korea
Jeehye Lee: Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon 34824, Korea
Ho Jin Jeong: Department of Preventive Medicine, Konkuk University School of Medicine, Seoul 05029, Korea
Hyeongsu Kim: Department of Preventive Medicine, Konkuk University School of Medicine, Seoul 05029, Korea
Jaehyeong An: Department of Neurology, National Medical Center, Seoul 04564, Korea
Sung Hyun Jo: Department of Neurology, National Medical Center, Seoul 04564, Korea
Kwang-Pil Ko: Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Jeoungbin Choi: Department of Biomedical Science, Seoul National University Graduate School, Seoul 03080, Korea

IJERPH, 2022, vol. 19, issue 5, 1-9

Abstract: A complete enumeration study was conducted to evaluate trends related to reperfusion therapies (intravenous thrombolysis (IVT) and endovascular treatment (EVT)) in acute ischemic stroke (AIS) in South Korea, according to sex, economic status, and age, over a 10-year period retrospectively, using the National Health Information Database (NHIS-2020-1-481). This study included AIS patients aged ≥20 years who were hospitalized in a general hospital or tertiary hospital for ≥4 days and underwent brain imaging during the same period. Study participants were classified by sex, economic status (Medical Aid beneficiaries and National Health Insurance beneficiaries) and age (20–44, 45–64, 65–79, and ≥80 years). Women showed a significantly lower OR (Odds ratio) than men in IVT (OR: 0.75; 95% CI: 0.73–0.77), EVT (OR: 0.96; 95% CI: 0.93–0.99), and any therapy (OR: 0.82; 95% CI: 0.80–0.84). The Medical Aid beneficiaries showed significantly lower OR in IVT (OR 0.91, 95% CI 0.88–0.95), EVT (OR 0.93, 95% CI 0.89–0.98), and either therapy (OR 0.92, 95% CI 0.90–0.95) than the National Health Insurance beneficiaries. This study showed sex and economic disparity related to reperfusion therapies in patients with AIS in Korea.

Keywords: acute stroke; healthcare disparities; thrombolytic therapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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