The Korean Journal of Medicine

  • 제86권5호
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  • Pages.585-592
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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한 종합병원에 입원한 노숙인 당뇨병 환자의 당뇨관리 실태와 동반 질환

The Quality of Medical Care Provided to Homeless Diabetes Patients in a General Hospital in Seoul, and the Prevalence of Diabetes Comorbidities

  • 범선희 (서울특별시 서울의료원 내과) ;
  • 오무경 (강원대학교병원 예방의학과) ;
  • 안철우 (연세대학교 의과대학 내과학교실)
  • Beom, Sun Hee (Department of Internal Medicine, Seoul Medical Center) ;
  • Oh, Moo Kyung (Department of Preventive Medicine, Kangwon National University Hospital) ;
  • Ahn, Chul Woo (Department of Internal Medicine, Yonsei University of Collage of Medicine)
  • 투고 : 2013.07.24
  • 심사 : 2013.11.18
  • 발행 : 2014.05.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 노숙인은 의료취약계층으로 비노숙인에 비해 질병 발생이 많고 사망률도 더 높다. 최근 급격하게 증가하고 있는 당뇨병은 합병증이 높은 만성 질환으로 치료와 관리가 중요하다. 본 연구의 목적은 병원에 내원한 노숙인 당뇨병 환자의 관리 실태 및 동반 질환을 알아보고 파악하는 데 있다. 방법: 2011년 3월 25일부터 2012년 12월 31일까지 서울시 소재의 한 종합병원에 내원한 노숙인 당뇨병 환자들을 대상으로 후향적 의무기록 조사를 하였다. 노숙인 당뇨병 환자군(n = 82)과 비노숙인 당뇨병 환자군(n = 242)으로 분류하였다. 양 군 간에 임상적 소견, 검사실 소견, 동반 질환과 합병증 등을 비교하였다. 결과: 노숙인 당뇨병 환자는 비노숙인 환자에 비해 당뇨병 치료를 불규칙적으로 받는 경우가 더 많았고 다른 질병으로 병원에 내원한 후에 당뇨병으로 진단된 경우도 더 많았다. 노숙인 당뇨병 환자의 당화혈색소가 비노숙인에 비해 더 높았고 급성 감염병, 두개내출혈, 말초동맥 질환과 폐결핵을 동반하는 경우가 더 많았다. 다변량분석 결과 노숙인 당뇨병 환자에서 비노숙인에 비해 급성 감염병과 폐결핵의 유병률이 유의하게 높은 것으로 나타났다. 결론: 병원에 내원한 노숙인 당뇨병 환자에서 비노숙인 환자에 비해 급성 감염병과 폐결핵의 동반 질환이 더 많이 관찰되었으며 이에 대한 관심이 필요하다.

Background/Aims: As an underprivileged population, homeless people have a higher incidence of morbidity and mortality than do non-homeless people. Diabetes mellitus is a chronic disease associated with high complication rates; its incidence is increasing rapidly and it requires prompt, adequate treatment and care. Therefore, we investigated the quality of medical care provided to homeless diabetics in a general hospital and comorbidities associated with diabetes. Methods: Between March 25, 2011 and December 31, 2012, we retrospectively investigated the medical records of the diabetes patients at a general hospital in Seoul. We assigned the patients into two groups: homeless (n = 82) and non-homeless (n = 242) patients. We subsequently compared the clinical and laboratory findings, comorbidities, and complications between the two groups. Results: The homeless diabetics received treatment less regularly than the non-homeless patients and were diagnosed with diabetes while visiting the hospital for the treatment of other diseases. The homeless patients had higher glycated hemoglobin A1c levels than the non-homeless patients. The homeless patients had a higher rate of other diseases, such as peripheral artery disease, acute infectious disease, intracranial hemorrhage, and pulmonary tuberculosis; a higher incidence of acute infectious disease (odds ratio [OR], 15.671; 95% confidence interval [CI], 5.115-48.070); and a higher prevalence of pulmonary tuberculosis (OR, 6.423; 95% CI, 1.785-23.116) than the non-homeless patients, as determined by multivariate analysis. Conclusions: Comorbid acute infectious disease and pulmonary tuberculosis were found more frequently in homeless diabetes patients presenting to the hospital than in non-homeless diabetes patients. Therefore, attention should be paid to this differentiating factor.

키워드

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피인용 문헌

  1. 쉼터거주자의 건강관리실태 및 대안 vol.28, pp.3, 2014, https://doi.org/10.5932/jkphn.2014.28.3.536
  2. 노숙인들의 중독 및 정신건강 실태에 관한 조사 vol.29, pp.5, 2016, https://doi.org/10.5351/kjas.2016.29.5.977