The Effect of Contextual Factors on Unintentional Injury Hospitalization: from the Korea National Hospital Discharge Survey

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2018 Mar 15

PMID 29534704

Citations 2

Authors

Hye Ah Lee

Hyejin Han

Seonhwa Lee

Bomi Park

Bo Hyun Park

Won Kyung Lee

Ju Ok Park

Sungok Hong

Young Taek Kim

Hyesook Park

Affiliations

Soon will be listed here.

Abstract

Background: It has been suggested that health risks are affected by geographical area, but there are few studies on contextual effects using multilevel analysis, especially regarding unintentional injury. This study investigated trends in unintentional injury hospitalization rates over the past decade in Korea, and also examined community-level risk factors while controlling for individual-level factors.

Methods: Using data from the 2004 to 2013 Korea National Hospital Discharge Survey (KNHDS), trends in age-adjusted injury hospitalization rate were conducted using the Joinpoint Regression Program. Based on the 2013 KNHDS, we collected community-level factors by linking various data sources and selected dominant factors related to injury hospitalization through a stepwise method. Multilevel analysis was performed to assess the community-level factors while controlling for individual-level factors.

Results: In 2004, the age-adjusted unintentional injury hospitalization rate was 1570.1 per 100,000 population and increased to 1887.1 per 100,000 population in 2013. The average annual percent change in rate of hospitalizations due to unintentional injury was 2.31% (95% confidence interval: 1.8-2.9). It was somewhat higher for females than for males (3.25% vs. 1.64%, respectively). Both community- and individual-level factors were found to significantly influence unintentional injury hospitalization risk. As community-level risk factors, finance utilization capacity of the local government and neighborhood socioeconomic status, were independently associated with unintentional injury hospitalization after controlling for individual-level factors, and accounted for 19.9% of community-level variation in unintentional injury hospitalization.

Conclusion: Regional differences must be considered when creating policies and interventions. Further studies are required to evaluate specific factors related to injury mechanism.

Citing Articles

Sociodemographic distribution and correlates of nonfatal unintentional non-traffic-related injuries in Kenya: Results from the 2014 demographic and health survey.

Abio A, Ngum P, Wilson M, Barnighausen T, Lule H Health Sci Rep. 2023; 6(6):e1323.

PMID: 37292100 PMC: 10246455. DOI: 10.1002/hsr2.1323.

Data resource profile: the Korea National Hospital Discharge In-depth Injury Survey.

Lee Y, Hong S, Park S, Park M, Wang K, Jo M Epidemiol Health. 2021; 43:e2021052.

PMID: 34412448 PMC: 8769804. DOI: 10.4178/epih.e2021052.

References

Galobardes B, Shaw M, Lawlor D, Lynch J, Davey Smith G . Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2005; 60(1):7-12. PMC: 2465546. DOI: 10.1136/jech.2004.023531. View

Laflamme L, Hasselberg M, Burrows S . 20 Years of Research on Socioeconomic Inequality and Children's-Unintentional Injuries Understanding the Cause-Specific Evidence at Hand. Int J Pediatr. 2010; 2010. PMC: 2913857. DOI: 10.1155/2010/819687. View

McClure R, Kegler S, Davey T, Clay F . Contextual Determinants of Childhood Injury: A Systematic Review of Studies With Multilevel Analytic Methods. Am J Public Health. 2015; 105(12):e37-43. PMC: 4638267. DOI: 10.2105/AJPH.2015.302883. View

Lee J, Lee W, Noh M, Khang Y . Does a geographical context of deprivation affect differences in injury mortality? A multilevel analysis in South Korean adults residing in metropolitan cities. J Epidemiol Community Health. 2014; 68(5):457-65. DOI: 10.1136/jech-2013-203082. View

Ko H, Kim J, Kim D, Kim S, Park Y, Kim C . Association between local government social expenditures and mortality levels in Korea. J Prev Med Public Health. 2013; 46(1):1-9. PMC: 3567320. DOI: 10.3961/jpmph.2013.46.1.1. View

Pickett K, Pearl M . Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health. 2001; 55(2):111-22. PMC: 1731829. DOI: 10.1136/jech.55.2.111. View

Kang Y, Ko Y, Kim Y, Sung K, Kim H, Choi H . Korea Community Health Survey Data Profiles. Osong Public Health Res Perspect. 2015; 6(3):211-7. PMC: 4551141. DOI: 10.1016/j.phrp.2015.05.003. View

Merlo J, Chaix B, Yang M, Lynch J, Rastam L . A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon. J Epidemiol Community Health. 2005; 59(6):443-9. PMC: 1757045. DOI: 10.1136/jech.2004.023473. View

Cubbin C, LeClere F, Smith G . Socioeconomic status and injury mortality: individual and neighbourhood determinants. J Epidemiol Community Health. 2000; 54(7):517-24. PMC: 1731715. DOI: 10.1136/jech.54.7.517. View

10.

Kim M, Subramanian S, Kawachi I, Kim C . Association between childhood fatal injuries and socioeconomic position at individual and area levels: a multilevel study. J Epidemiol Community Health. 2007; 61(2):135-40. PMC: 2465637. DOI: 10.1136/jech.2006.047738. View

11.

Lee H, Park H, Kim H, Jung-Choi K . The effect of community-level smoke-free ordinances on smoking rates in men based on Community Health Surveys. Epidemiol Health. 2015; 36:e2014037. PMC: 4371388. DOI: 10.4178/epih/e2014037. View

12.

Lee W, Lim D, Park H . Disability-Adjusted Life Years (DALYs) for Injuries Using Death Certificates and Hospital Discharge Survey by the Korean Burden of Disease Study 2012. J Korean Med Sci. 2016; 31 Suppl 2:S200-S207. PMC: 5081302. DOI: 10.3346/jkms.2016.31.S2.S200. View

13.

Poulos R, Hayen A, Finch C, Zwi A . Area socioeconomic status and childhood injury morbidity in New South Wales, Australia. Inj Prev. 2007; 13(5):322-7. PMC: 2610604. DOI: 10.1136/ip.2007.015693. View