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

• Published in: International journal of environmental research and public health 2022-03, Vol.19 (5), p.3050
• Main Authors: Moon, Jusun, Shin, Jinyoung, Lee, Jeehye, Jeong, Ho Jin, Kim, Hyeongsu, An, Jaehyeong, Jo, Sung Hyun, Ko, Kwang-Pil, Choi, Jeoungbin
• Format: Article
• Language: English
• Subjects: Age groups; Blood clots; Brain Ischemia - epidemiology; Brain Ischemia - therapy; Cardiovascular system; Clinical medicine; Codes; Economics; Endovascular Procedures - adverse effects; Endovascular Procedures - methods; Enumeration; Female; Health insurance; Hospitals; Humans; Insurance; Intravenous administration; Ischemia; Ischemic Stroke - epidemiology; Ischemic Stroke - therapy; Low income groups; Male; Medical aid; National Health Programs; Neuroimaging; Older people; Patients; Population; Population studies; Population-based studies; Reimbursement; Reperfusion; Retrospective Studies; Sex; Stroke; Stroke - epidemiology; Stroke - etiology; Stroke - therapy; Thrombolysis; Thrombolytic Therapy; Treatment Outcome; Trends; Womens health
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph19053050

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.