Health Status and Self-management Barriers in People with Diabetes -A Comparison by Medicaid Beneficiary Status-

성인당뇨병환자의 건강수준 및 질병관리장애요인 -의료급여환자와 건강보험환자의 비교-

Academic interest has been drastically increased for the health disparities due to socioeconomic factors. For those who have a chronic illness such as diabetes, various psychosocial barriers related to illness management might affect and aggravate this disparity. This study focused on illness management barriers experienced by people with diabetes, and examined the differences by their Medicaid beneficiary status. The between group differences in illness management barriers, family support and health status were examined as well as the association between illness management barriers and health status. The sample of this study consists of 144 community dwelling adults who have diabetes, recruited from an outpatient diabetes clinic and a community welfare center. Medicaid beneficiaries reported poorer health status, and experienced more illness management barriers compared to their counterparts. Statistically significant differences were observed in barriers due to mental health, financial status, and lack of support. The between group difference in health status remained significant after controlling for the effect of demographic characteristics and illness related factors. Social work practitioners working with this population should address these illness management barriers to reduce socioeconomic health disparity.

본 연구는 성인당뇨병 환자들을 대상으로 의료급여수급여부에 따라 건강수준 및 질병관리 장애요인에 차이가 나타나는지를 분석하고 질병관리 장애요인이 건강수준에 미치는 영향을 살펴보았다. 자료수집은 서울의 종합병원 당뇨병클리닉 및 지역사회 복지기관에서 편의표집한 55세이상 성인당뇨병 환자 144명을 대상으로 조사를 실시하였다. 분석결과, 의료급여환자가 건강보험환자에 비하여 건강수준이 더 나쁘다고 인식하고 있었으며, 질병관리 장애요인을 더 많이 경험하고 있는 것으로 나타났다. 건강보험환자와 의료급여환자간 건강수준의 차이는 인구학적 요인 및 질병관련 특성들을 통제한 이후에도 유의하였다.