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Eun-Jung Kim 1 Article
Effects of adults’ health behaviors and combinations thereof on health outcomes: an analysis using National Health Insurance Service of Korea cohort data
Hyun-Jung Park, Eun-Jung Kim
Epidemiol Health. 2019;41:e2019042.   Published online October 8, 2019
DOI: https://doi.org/10.4178/epih.e2019042
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The purpose of this study was to estimate the effects of health-risk behaviors, alone and in combination, on health outcomes.
METHODS
This study used sample cohort data provided by the National Health Insurance Service focusing on the use of hospital services, direct medical expenses, length of stay, and re-entry rate according to health-risk behaviors. A frequency analysis and the chi-square test were used to investigate associations between the demographic characteristics of study subjects and their health-risk behaviors. The strength of the association of each factor was calculated as the odds ratio in a crossover analysis.
RESULTS
Obesity had the largest effect, especially in combination with smoking and drinking. In particular, significant associations were shown with the duration of hospitalization and direct medical expenses. After adjustment for sex, age, economic status, and pre-existing medical conditions, the duration of hospitalization was 7.37 times longer and that of medical expenses was 5.18 times higher in the obese group relative to the non-obese group. Drinking showed a statistically significant association with the number of days of hospitalization. After adjusting for the control variables, the number of hospital days was 1.24 longer in the drinking group than in the non-drinking group.
CONCLUSIONS
An analysis of combinations of health risk factors showed obesity had the largest effect.
Summary
Korean summary
본 연구에서는 건강위해행동이 건강결과에 미치는 영향을 추정하고, 건강위해행동 간 상호작용을 분석하여 보다 다차원적 측면에서 건강위해행동과 건강결과 간 관계를 다루었다. 그 결과, 흡연, 비만, 음주 중 1개의 위해행위를 가지고 있는 경우, 흡연 집단에서 모든 건강결과와의 관련성이 통계적으로 유의미하지 않았으나, 비만의 경우, 입원일수와 직접의료비간의 관련성이 유의미하였고, 특히, 비만한 집단의 경우, 성별, 연령, 경제적 수준 및 기저 질환을 보정한 후, 그렇지 않은 집단과 비교하여 입원일수와 의료비의 유의미한 증가가 확인되었다. 건강위험행태요인의 조합을 조사하여, 어떤 경우 건강행태에 영향을 크게 미치는지를 분석한 결과, 비만의 영향이 가장 큰 것으로 분석되었으며, 흡연과 음주, 단일의 건강위험행태보다, 비만과 함께 건강위험행태가 동반되었을 때 그 영향이 증가하였다.
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Citations

Citations to this article as recorded by  
  • Risk and protective behaviors for chronic non-communicable diseases among Brazilian adults
    R.B.N. de Carvalho, F. Rauber, R.M. Claro, R.B. Levy
    Public Health.2021; 195: 7.     CrossRef

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