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Journal of Preventive Medicine and Public Health 2006;39(2): 141-148.
Relationship of Socioeconomic Factors with Medical Utilization for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia in a South Korean Community.
Han Hae Kim, Kyoung Ae Kong, Hun Jae Lee, Hana Yoon, Bo Eun Lee, Ok Ryun Moon, Hyesook Park
1Korea Institute for Health and Social Affairs, Korea.
2Department of Preventive Medicine, Ewha Womans University, Korea. hpark@ewha.ac.kr
3Department of Social Medicine, Inha Univeras University, Korea.
4Department of Urology, Ewha Womans University, Korea.
5Division of Chronic Disease Surveillance, Korea Center for Disease Control and Prevention, Korea.
6School of Public Health, Seoul National University, Korea.
ABSTRACT
OBJECTIVES: We wanted to evaluate the medical underutilization for benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) among Korean elderly men and we wanted to determine their associated factors. METHODS: This study was conducted on 239 men with LUTS and 116 men with BPH who were compatible with the diagnostic criteria from a total of 641 participants. These participants were over 50 years old and they were randomly chosen in a community-based study for estimating the prevalence of BPH. Using a self-reported questionnaire, we surveyed the sociodemographics, health status, quality of life, lower urinary tract symptoms, medical utilization and reasons for not seeking treatment. RESULTS: Only 27.6% of the men with LUTS and 31.0% of the men with BPH reported having visited a doctor for urinary symptoms. The reasons for not visiting a doctor were, in order of responses from the group with LUTS: 'considered the symptoms as a part of the normal ageing process', 'not enough time to visit a doctor', 'financial difficulty' and 'the symptoms were not severe or bothersome'. Regarding BPH, the responses were the same as those of the group with LUTS however, 'financial difficulty' placed second. Among the men with experience of visiting a doctor for urinary symptoms, 33.3% of those with LUTS and 28.1% of those with BPH were not treated. The most common reason in both groups was 'the symptoms were not severe to be treated'. On a multiple logistic regression analysis, the larger size household (odds ratio (OR) 3.03, 95% confidence interval (CI)=1.40-6.54) and an unsatisfactory quality of life related with urinary symptoms (OR 2.98, 95% CI=1.23-7.21) were associated with medical utilization in the group of LUTS. For BPH, the current employment status was related with the medical utilization (OR 2.80, 95% CI=1.10-7.11), in addition to the larger size household (OR 3.24, 95% CI=1.14-9.21). CONCLUSIONS: Many men with urinary symptoms do not visit a doctor. This medical underutilization for people with LUTS and BPH may be associated with economic status in Korea.
Key words: Lower urinary tract symptoms; Benign prostatic hyperplasia; Medical utilization
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